Upper gastrointestinal hemorrhage in African-American and Hispanic elderly patients.
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.
Akhtar
A J
AJ
Department of Internal Medicine, Charles R. Drew University of Medicine and Science/King-Drew Medical Center, Los Angeles, California 90059, USA.
Ganesan
K
K
Yoshikawa
T T
TT
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