Upper gastrointestinal bleeding in elderly patients in a Tunisian hospital: A retrospective study

Chaabane, N. Ben; Youssef, H Ben; Loghmeri, Hichem; Helara, Olfa; Melki, W.; Bdioui, F.; Safer, L.; Saffar, H.

doi:10.1016/j.ajg.2011.06.001

Cited by 4 publications

(18 citation statements)

References 16 publications

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“…[10] Rebleeding was defined as a new bleeding episode within the first 3 days after the initial hemorrhage has stopped. [3] Patients with the following features were excluded from the study; aged <65 years (n=176), hematemesis caused by swallowing caustic agents (n=1) or foreign bodies (n=6), hemorrhage from upper respiratory tract (n=2), nose bleeding (n=7) and those who had inflammatory bowel disease (n=19).…”

Section: Methodsmentioning

confidence: 99%

“…We defined "elderly" as those between 65 and 79 years of age [9] and "very elderly" as those older than 79 years of age. [3] Data was collected from medical records of all patients using computerized hospital database (according to ICD-10 ''International Statistical Classification of Diseases and Related Health Problems''K52, K92, K25, K92.1, K92.2) and a standard form that included demographic features, clinical characteristics and risk factors. Details like initial vital signs and presence of hemodynamic instability, rebleeding, history of operation, comorbidities, presence of alcohol abuse (social drinkers were excluded) and transfusion requirements were recorded.…”

Section: Methodsmentioning

confidence: 99%

“…However this condition is still a critical problem for the elderly. [3,8] There is limited information on sociodemographic features, etiological characteristics and clinical outcomes of the very elderly patients presenting to ED with AUGIH in Turkey.…”

Section: Introductionmentioning

confidence: 99%

“…This rate is expected to reach 12.2% in the year 2020. [3,4] It is a known fact that elderly people need ED and intensive care units more often than the other age groups. [5] The incidence of AUGIH increases with age [3] and the percentage of patients aged 60 and older with a diagnosis of AUGIH increased from 46.1% in 1987 to 63.2% in 2001.…”

Section: Introductionmentioning

confidence: 99%

“…[3,4] It is a known fact that elderly people need ED and intensive care units more often than the other age groups. [5] The incidence of AUGIH increases with age [3] and the percentage of patients aged 60 and older with a diagnosis of AUGIH increased from 46.1% in 1987 to 63.2% in 2001. [6] Age also has been considered as a meaningful prognostic factor for mortality of patients after AUGIH.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Risk Factors and Clinical Characteristics of Elderly Patients with Acute Upper Gastrointestinal Hemorrhage

et al. 2012

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of Risk Factors and Clinical Characteristics of Elderly Patients with Acute Upper Gastrointestinal Hemorrhage

et al. 2012

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ICU admission characteristics and mortality rates among elderly and very elderly patients

et al. 2012

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Purpose The effect of advanced age per se versus severity of chronic and acute diseases on the short- and long-term survival of older patients admitted to the intensive care unit (ICU) remains unclear. Methods Intensive care unit admissions to the surgical ICU and medical ICU of patients older than 65 years were analyzed. Patients were divided into three age groups: 65–74, 75–84, and 85 and above. The primary endpoints were 28-day and 1-year mortality. Results The analysis focused on 7,265 patients above the age of 65, representing 45.7 % of the total ICU population. From the first to third age group there was increased prevalence of heart failure (25.9–40.3 %), cardiac arrhythmia (24.6–43.5 %), and valvular heart disease (7.5–15.8 %). There was reduced prevalence of diabetes complications (7.5–2.4 %), alcohol abuse (4.1–0.6 %), chronic obstructive pulmonary disease (COPD) (24.4–17.4 %), and liver failure (5.0–1.0 %). Logistic regression analysis adjusted for gender, sequential organ failure assessment, do not resuscitate, and Elixhauser score found that patients from the second and third age group had odds ratios of 1.38 [95 % confidence interval (CI) 1.19–1.59] and 1.53 (95 % CI 1.29–1.81) for 28-day mortality as compared with the first age group. Cox regression analysis for 1-year mortality in all populations and in 28-day survivors showed the same trend. Conclusions The proportion of elderly patients from the total ICU population is high. With advancing age, the proportion of various preexisting comorbidities and the primary reason for ICU admission change. Advanced age should be regarded as a significant independent risk factor for mortality, especially for ICU patients older than 75.

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At admission hemodynamic instability is associated with increased mortality and rebleeding rate in acute gastrointestinal bleeding: a systematic review and meta-analysis

Tari,

Frim,

Stolcz

et al. 2023

Therap Adv Gastroenterol

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Background: Acute gastrointestinal bleeding (GIB) is a life-threatening event. Around 20–30% of patients with GIB will develop hemodynamic instability (HI). Objectives: We aimed to quantify HI as a risk factor for the development of relevant end points in acute GIB. Design: A systematic search was conducted in three medical databases in October 2021. Data sources and methods: Studies of GIB patients detailing HI as a risk factor for the investigated outcomes were selected. For the overall results, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated based on a random-effects model. Subgroups were formed based on the source of bleeding. The Quality of Prognostic Studies tool was used to assess the risk of bias. Results: A total of 62 studies were eligible, and 39 were included in the quantitative synthesis. HI was found to be a risk factor for both in-hospital (OR: 5.48; CI: 3.99–7.52) and 30-day mortality (OR: 3.99; CI: 3.08–5.17) in upper GIB (UGIB). HI was also associated with higher in-hospital (OR: 3.68; CI: 2.24–6.05) and 30-day rebleeding rates (OR: 4.12; 1.83–9.31) among patients with UGIB. The need for surgery was also more frequent in hemodynamically compromised UGIB patients (OR: 3.65; CI: 2.84–4.68). In the case of in-hospital mortality, the risk of bias was high for 1 (4%), medium for 13 (48%), and low for 13 (48%) of the 27 included studies. Conclusion: Hemodynamically compromised patients have increased odds of all relevant untoward end points in GIB. Therefore, to improve the outcomes, adequate emergency care is crucial in HI. Registration: PROSPERO registration number: CRD42021285727.

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Upper gastrointestinal bleeding in elderly patients in a Tunisian hospital: A retrospective study

Cited by 4 publications

References 16 publications

Evaluation of Risk Factors and Clinical Characteristics of Elderly Patients with Acute Upper Gastrointestinal Hemorrhage

Evaluation of Risk Factors and Clinical Characteristics of Elderly Patients with Acute Upper Gastrointestinal Hemorrhage

ICU admission characteristics and mortality rates among elderly and very elderly patients

At admission hemodynamic instability is associated with increased mortality and rebleeding rate in acute gastrointestinal bleeding: a systematic review and meta-analysis

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