title: Gastrointestinal bleeding in patients aged 85 years and older.
abstract: The aging of the population is associated with the increased risk of chronic diseases, and greater consumption of drugs used in their treatment, which may lead towards gastrointestinal bleeding.The aim of the study was to analyze the reasons, treatment results, complications and mortality connected with gastrointestinal bleeding in patients aged 85 years and older.Material and methods. The study comprised the retrospective analysis of 84 patients, aged between 85 and 97 years admitted to the Department of General Surgery with diagnosis of gastrointestinal bleeding, during the period between 2005 and 2010. The results were compared to a younger control group of 151 patients (mean age-53 years) with gastrointestinal bleeding, admitted to the department during the same period. Diagnosis was based on the history, physical examination, endoscopy, morphology and biochemical lab results. Analysis considered the therapeutic method used, treatment results, complications and hospital mortality. The endoscopic picture and risk of recurrent bleeding in patients with upper gastrointestinal hemorrhage was evaluated by means of the clinical Forrest scale. Results were subject to statistical analysis.Results. Most of the gastrointestinal bleeding cases considering patients aged 85 years and older concerned the upper gastrointestinal tract (41.67%). Thirty (35.71%) patients were on drugs affecting the coagulation system. On admission, the average hemoglobin concentration level in the elderly was comparable to results observed in case of the control group. Considering patients aged 85+, drugs affecting the coagulation system were used statistically more frequently, as compared to younger patients. Recurrence of bleeding was observed in 10 (11.9%) study group patients.Overall mortality due to gastrointestinal bleeding in elderly patients amounted to 20.24% and was statistically higher, as compared to the control group- 7.2%.Conclusions. Treatment results in case of gastrointestinal bleeding in the elderly patients (above 85 years) are burdened with a higher mortality rate. Different diagnostic and therapeutic methods should be applied in case of elderly patients (above 85 years), in order to increase their chance of survival. The problem of aging is an epidemiological phenomenon and gastrointestinal bleeding will become an increasing problem, needing to be solved in everyday clinical practice.
authors.affiliation: Department of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, Department of Surgery and Surgical Nursing, J. Kochanowski University, ul. Grunwaldzka 45, Kielce.
authors.forename: Dorota
authors.initials: D
authors.lastname: Kozieł
authors.forename: Jarosław
authors.initials: J
authors.lastname: Matykiewicz
authors.forename: Stanisław
authors.initials: S
authors.lastname: Głuszek
mesh_terms: D017677:Age Distribution; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D015984:Causality; D002423:Cause of Death; D003920:Diabetes Mellitus / Q000453:epidemiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents