[Peptic ulcer hemorrhage in the elderly].
BACKGROUND
The aim of this study was to investigate the efficacy of endoscopic injection therapy on the clinical outcome of elderly patients with peptic ulcer bleeding.


METHODS
From January 1995 to December 1998, 738 patients with acute peptic ulcer bleeding were observed in the First Division of General Surgery, University of Verona: 359 aged <70 years and 379 =/>70 years. History, clinical and endoscopic findings and outcome were prospectively collected and analyzed comparing old (=/>70 yrs) and young (<70 yrs) patients. Ulcers with active or sign of recent bleeding were submitted to injection therapy using epinephrine and 1% polidocanol.


RESULTS
Coexisting diseases were significantly more present in the elderly group except for liver cirrhosis that affected preferentially young patients (12.3 versus 4.0%; p<0.001). Endoscopic treatment was performed in a similar percentage between young and elderly patients (respectively 64.9 e 61.5%) and also the rebleeding rate (14.2 versus 13.2) and the mean duration of hospitalisation were not different. The overall mortality was 12.7% in the elderly group and 8.3% in the young group (p=0.04), whereas mortality after surgery was significantly higher in the young group (respectively 57.1 versus 8.3%; p=0.037).


CONCLUSIONS
The clinical and endoscopic features and reebleeding rate were not different between elderly and young patients. Patients aged 70 years or older have a higher number of associated medical diseases except for liver cirrhosis conditions and a highest overall mortality whereas the risk of death after surgery is lower than in the younger group.
De Manzoni
G
G
I Divisione Clinicizzata di Chirurgia, Cattedra di Chirurgia d'Urgenza, Università degli Studi di Verona, Verona, Italy.
Catalano
F
F
Festini
M
M
Lombardo
F
F
Kind
R
R
Pachera
S
S
Rodella
L
L
Ruzzenente
A
A
Valloncini
E
E
Zerman
G
G
D000208:Acute Disease; D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications*; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000628:therapy*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use; D013276:Stomach Ulcer / Q000150:complications*
D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols; D004837:Epinephrine