Endoscopic hemostasis: safe treatment for peptic ulcer patients aged 80 years or older?
OBJECTIVE
Recently, the number of peptic ulcer patients aged 80 years or older has been increasing. However, little information is available concerning therapeutic endoscopy for these patients. The objective of this study was to evaluate the efficacy of endoscopic hemostasis for peptic ulcer bleeding in patients aged 80 years or older.


METHODS
In this 7-year study, bleeding peptic ulcer patients were divided into group A (>/=80 years old) and group B (<80 years), for which prospective data, endoscopic findings and outcomes of endoscopic treatment were compared.


RESULTS
Of the 459 patients who underwent endoscopic hemostasis for peptic ulcer bleeding, the 42 patients (average age 84 +/- 3 years) in group A had a significantly higher incidence of concomitant disease, lower hemoglobin, transfusional requirement over 800 mL and lower serum albumin than the 417 patients (average age 55 +/- 13 years) in group B. Significantly more patients in group A had large gastric ulcers. More patients in group A had ulcers located at the proximal third of the stomach, which is technically difficult to treat endoscopically. Nevertheless, all patients in groups A and B underwent initial hemostasis successfully. The rebleeding rate was not significantly different between group A and B. Neither group had hospital deaths nor complications related to endoscopic procedures.


CONCLUSIONS
Endoscopic hemostasis for peptic ulcer bleeding in patients aged 80 years or older is effective and safe. Increasing age may no longer be a risk factor for rebleeding and hospital death after endoscopic hemostasis for peptic ulcer bleeding.
Yamaguchi
Yasuharu
Y
Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan. yasuharu@kyorin-u.ac.jp
Yamato
Taro
T
Katsumi
Naoya
N
Morozumi
Katsuro
K
Abe
Takashi
T
Ishida
Hitoshi
H
Takahashi
Shin'ichi
S
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D012449:Safety; D013276:Stomach Ulcer / Q000150:complications* / Q000473:pathology / Q000628:therapy*