Effects of age and drug use on lower gastrointestinal bleeding: a retrospective single-center experience

Lower gastrointestinal bleeding is a prevalent issue in the general population, particularly among older adults. Identifying risk factors is essential for improving healthcare outcomes. This study seeks to evaluate the clinical outcomes related to the use of medications recognized as risk factors, as well as the influence of age, in patients experiencing lower gastrointestinal hemorrhage. The primary endpoint of the study is to examine the effect of age and medication use on 30-day mortality, while the secondary endpoint was to investigate the need for endoscopic treatment, amount of transfusion, need for surgery-embolization, and length of hospital stay.

A retrospective cohort analysis was conducted on patients with lower gastrointestinal bleeding who were admitted to the emergency department at a single tertiary referral center. Patients were divided into two groups: those under 65 years of age and those aged 65 and older. Additionally, the older patients were further categorized into subgroups based on the specific antiplatelet or anticoagulant medications they were taking. We examined the demographic information of the patients, their presenting findings, colonoscopic diagnoses, the number of erythrocyte transfusions received, the need for embolization or surgery, the length of hospital stay, and the rates of 30-day mortality.

A total of 181 patients were retrospectively reviewed. Of the patients, 113 (62.4%) were aged over 65 years, while 68 (37.6%) were aged under 65 years. The most common cause of bleeding in geriatric patients is colonic diverticula (39%), while in the other group it is hemorrhoids/anal fissures (35%). The 30-day mortality, need for transfusion, number of transfusions, and length of hospital stay were higher in the geriatric group. 105 patients (58%) were receiving anticoagulant, antiplatelet, or nonsteroidal anti-inflammatory drugs. In geriatric patients, medication history did not affect endoscopic treatment, 30-day mortality, surgical needs, the number and amount of transfusions, or length of hospital stay.

Lower gastrointestinal bleeding has more adverse outcomes in geriatric people. Although anticoagulant and antiplatelet medications increase the risk of bleeding, they have not significantly influenced the clinical outcomes associated with it.