title: Upper gastrointestinal bleeding in elderly patients in a Tunisian hospital: A retrospective study.
abstract: OBJECTIVE
  The older age group presents a major problem in the management of acute gastrointestinal bleeding with a relatively high mortality. The study aims to describe the background characteristics, causes and outcome of acute upper gastrointestinal bleeding in the elderly in Tunisia.
  
  
  METHODS
  We retrospectively reviewed data of 401 patients aged≥60 years presenting with upper gastrointestinal bleeding. Information collected included history, physical examination findings, laboratory data, endoscopic findings and length of hospital stay. Patients were divided into two groups: group A (65-79 years) and group B (>79 years).
  
  
  RESULTS
  Group A included 315 patients and group B 86 patients. There was a male preponderance in both groups. Co-morbidity (p<0.01) and use of non-steroidal anti-inflammatory drugs (NSAIDs) or anti-platelet drugs (p<0.01) were more common in group B. Oesophagitis was the cause of bleeding in 38.37% in group B, as compared with 19% in group A. The main cause of bleeding in group A was peptic ulcer. Rebleeding (6/86) and emergency surgery (1/86) were rare in group B and not different from those in group A. However, the bleeding-related mortality in the very elderly group was higher (13.9% vs. 4.76%; p=0.02). In multivariate analysis, only shock on admission was independently related to mortality (p=0.02).
  
  
  CONCLUSIONS
  Oesophagitis is the major cause of upper gastrointestinal haemorrhage in the very elderly patients. While rebleeding and emergency surgery rates are relatively low, the bleeding-related mortality was higher in the very elderly group.
authors: Hepatogastroenterology Department, Monastir Hospital, Monastir, Tunisia. nabilca@yahoo.fr
authors: Nabil
authors: N
authors: Ben Chaabane
authors: Hedi
authors: H
authors: Ben Youssef
authors: Hichem
authors: H
authors: Loghmeri
authors: Olfa
authors: O
authors: Helara
authors: Wissem
authors: W
authors: Melki
authors: Fethia
authors: F
authors: Bdioui
authors: Leila
authors: L
authors: Safer
authors: Hamouda
authors: H
authors: Saffar
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology*; D017052:Hospital Mortality / Q000639:trends; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007297:Inpatients; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends; D014416:Tunisia / Q000453:epidemiology