title: Upper gastrointestinal hemorrhage in African-American and Hispanic elderly patients.
abstract: OBJECTIVE
  To investigate the frequency and etiology of upper gastrointestinal hemorrhage (UGIH) in African-American and Hispanic elderly patients, and to determine the risks and benefits of endoscopic intervention.
  
  
  METHODS
  An inner-city county hospital serving predominantly African-American and Hispanic populations.
  
  
  METHODS
  Records of 290 patients, 65 to 95 years of age, with diagnosis of UGIH, were reviewed retrospectively, 12 White and 8 Asian patients were excluded.
  
  
  RESULTS
  Source of bleeding remained unidentified in 25 of 270 patients and they were also excluded. Endoscopic findings in 245 patients were: 59 gastric ulcers, 52 duodenal ulcers, 49 gastric erosions, 37 gastroesophageal varices, 25 Mallory Weiss tears, 15 angiodysplasias, 13 Dieulafoy's lesions, 12 portal hypertensive gastropathies, 8 esophageal cancers with bleeding, and 7 gastric cancers with bleeding; 32 patients had more than one lesion. Endoscopic therapy was administered to 159 patients, and was helpful in stopping bleeding and/or delaying surgery in 102 patients. Overall, there were 59 deaths, mostly due to underlying multiple system disease. There was no death directly due to endoscopy.
  
  
  CONCLUSIONS
  Acute UGIH in African-American and Hispanic elderly patients is a serious condition, associated with significant morbidity and mortality. Benefits of endoscopy should be offered to all such patients, and endoscopy should not be withheld because of age alone.
authors: Department of Internal Medicine, Charles R. Drew University of Medicine and Science/King-Drew Medical Center, Los Angeles, California 90059, USA.
authors: A J
authors: AJ
authors: Akhtar
authors: K
authors: K
authors: Ganesan
authors: T T
authors: TT
authors: Yoshikawa
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D006630:Hispanic or Latino; D006801:Humans; D015141:Los Angeles; D008297:Male; D012189:Retrospective Studies; D014505:Urban Population