The management of bleeding peptic ulcer in the elderly with heater probe thermocoagulation.
OBJECTIVE
The aim of this study was to compare the clinical characteristics of bleeding peptic ulcers in the elderly with those in younger patients, retrospectively.


METHODS
Between 1986 and 1994, 274 patients with bleeding peptic ulcers were treated with heater probe endoscopically. They were divided into 2 groups: 48 in the elder group (70 years of age or older) and 226 in the younger group (<70). We evaluated the rate of concomitant disease, rebleeding rate, incidence of emergency surgery, mortality and blood transfusion requirement between the 2 groups.


RESULTS
The incidence of concomitant disease was significantly higher in the elderly group (83.3%) than in the younger group (33.3%) (p<0.01). The rate of rebleeding (younger group 23.5% vs. elderly group 31.3%), the incidence of emergency surgery (5.8% vs. 6.3%, respectively) and the rate of mortality due to hemorrhage (2.2% vs. 4.2%, respectively) were similar in the 2 groups. There was no significant difference in the mean volume of blood transfused.


CONCLUSIONS
It was revealed that aggressive endoscopic hemostasis improved the mortality rate and the incidence of emergency surgery in elderly patients as well as in younger patients, provided that their general condition was monitored carefully.
Tanabe
S
S
Department of Internal Medicine, Kitasato University, Kanagawa, Japan.
Koizumi
W
W
Imaizumi
H
H
Kida
Y
Y
Kida
M
M
Yokoyama
Y
Y
Azumi
Y
Y
Mitsuhashi
T
T
Ohida
M
M
Saigenji
K
K
Hiki
Y
Y
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D004564:Electrocoagulation / Q000295:instrumentation*; D004724:Endoscopy; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome