title: Clinical Backgrounds and Outcomes of Elderly Japanese Patients with Gastrointestinal Bleeding.
abstract: OBJECTIVE
  Elderly gastrointestinal bleeding (GIB) patients sometimes cannot be discharged home. In some cases, they die after hemostasis, even following appropriate treatment. This study investigates the clinical backgrounds and outcomes of elderly Japanese GIB patients.
  
  
  METHODS
  The medical records of 185 patients (123 men, 62 women; mean age 68.2 years; range 10-99 years) with GIB symptoms who underwent esophagogastroduodenoscopy or colonoscopy to detect or treat the source of GIB were retrospectively reviewed. We compared the outcomes between patients ≤70 (n=85) and >70 (n=100) years. The clinical backgrounds of the patients who died or changed hospitals to undergo rehabilitation or receive palliative care were evaluated, as were the association of four factors with these poor outcomes: GIB (re-bleeding or uncontrolled bleeding), endoscopic procedure-related complications, exacerbation of the pre-existing comorbidity, and any complications that were not directly related to GIB.
  
  
  RESULTS
  Of the patients ≤70 and >70 years of age, three (3.5%) and 17 (17.0%), respectively, were transferred to another hospital (p=0.003). One (1.2%) and five (5.0%), respectively, died (p=0.144). All three patients ≤70 years old that changed hospitals did so because their comorbidities became worse. The reasons for changing hospitals in the 17 patients >70 years of age included exacerbation of a pre-existing comorbidity (41.1%, 7/17), other complications (35.4%, 6/17), GIB itself (17.6%, 3/17), and endoscopic procedure-related complications (5.9%, 1/17).
  
  
  CONCLUSIONS
  Although non-elderly and elderly GIB patients had similar mortality rates, many more elderly patients could not be discharged home for various reasons.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Iwatsuka
authors.forename: Takuji
authors.initials: T
authors.lastname: Gotoda
authors.forename: Shin
authors.initials: S
authors.lastname: Kono
authors.forename: Sho
authors.initials: S
authors.lastname: Suzuki
authors.forename: Naoko
authors.initials: N
authors.lastname: Yagi Kuwata
authors.forename: Chika
authors.initials: C
authors.lastname: Kusano
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002648:Child; D015897:Comorbidity; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality*; D016558:Hemostasis, Endoscopic / Q000379:methods / Q000401:mortality*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D012307:Risk Factors