Age is not a discriminating factor for outcomes of therapeutic upper gastrointestinal endoscopy.
OBJECTIVE
To compare the efficacy and complications of therapeutic endoscopy for acute nonvariceal upper gastrointestinal bleeding between the geriatric (aged 65 and older) and non-geriatric patients.


METHODS
A total of 134 out of 259 hospitalized patients in the year 2005 had high-risk endoscopic lesions in UGI endoscopy and received therapeutic endoscopy. Seventy-six out of 134 patients were aged 65 and older (44 men), while 58 patients were aged 64 and younger (51 men). We compared clinical presentations, co-morbidities, endoscopic therapeutic procedures, endoscopic treatment failure, hospitalization days, blood transfusion, post-endoscopy complications (fever, acute coronary syndrome, aspiration pneumonia), and in-hospital mortality after therapeutic endoscopy.


RESULTS
Geriatric patients had lower hemoglobin on arrival (9.19 +/- 2.7 vs. 10.64 +/- 2.46 g/dL, p = 0.002) and larger gastric ulcers (7.3 +/- 6.9 vs. 4.0 +/- 3.6 mm, p = 0.008). Failure of therapeutic endoscopy, defined as salvage endoscopy or surgery within 48 hours after first endoscopy, showed no difference (14% vs. 14%, p = 0.98). Hospitalization stay (mean 7.47 vs. 5.97 days, p = 0.2), blood transfusion more than 4 units (47% vs. 34%, p = 0.13), post-endoscopic complications, in-hospital mortality were all comparable between geriatrics and non-geriatrics.


CONCLUSIONS
Our results serve a scientific basis that age is not a discriminating factor for outcomes in current therapeutic endoscopy.
Lee
Tsung-Chun
TC
Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
Huang
Shih-Pei
SP
Yang
Ju-Yeh
JY
Chang
Chi-Yang
CY
Liou
Jyh-ming
JM
Liu
Chen-Hua
CH
Huang
Mao-Sen
MS
Wang
Hsiu-Po
HP
D000367:Age Factors; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome