Acute upper gastrointestinal bleeding in octogenarians: clinical outcome and factors related to mortality.
OBJECTIVE
To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians.


METHODS
We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (>80 years old).


RESULTS
Four hundred and sixteen patients over 65 years of age were hospitalized because of AUGIB. Group A included 269 patients and Group B 147 patients. Co-morbidity was more common in octogenarians (P=0.04). The main cause of bleeding was peptic ulcer in both groups. Rebleeding and emergency surgery were uncommon in octogenarians and not different from those in younger patients. In-hospital complications were more common in octogenarians (P=0.05) and more patients died in the group of octogenarians compared to the younger age group (P=0.02). Inability to perform endoscopic examination (P=0.002), presence of high risk for rebleeding stigmata (P=0.004), urea on admission (P=0.036), rebleeding (P=0.004) and presence of severe co-morbidity (P<0.0001) were related to mortality. In multivariate analysis, only the presence of severe co-morbidity was independently related to mortality (P=0.032).


CONCLUSIONS
While rebleeding and emergency surgery rates are relatively low in octogenarians with AUGIB, the presence of severe co-morbidity is the main factor of adverse outcome.
Theocharis
George J
GJ
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, University of Patras, Vironos 18, Patras 26224, Greece.
Arvaniti
Vassiliki
V
Assimakopoulos
Stelios F
SF
Thomopoulos
Konstantinos C
KC
Xourgias
Vassilis
V
Mylonakou
Irini
I
Nikolopoulou
Vassiliki N
VN
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006115:Greece / Q000453:epidemiology; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D010437:Peptic Ulcer / Q000150:complications / Q000401:mortality / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D041742:Upper Gastrointestinal Tract / Q000473:pathology*; D014508:Urea / Q000032:analysis
D014508:Urea