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Acute upper gastrointestinal bleeding in the aged. A retrospective analysis of 100 cases
Insights
Gastrointestinal bleeding in older adults is often caused by benign conditions like peptic ulcers. Malignancy incidence was 23%, but mortality for benign causes was low, suggesting potential for improvement.
Area of Science:
- Gastroenterology
- Geriatrics
Background:
- Acute gastrointestinal bleeding is a significant concern in elderly patients.
- Understanding the causes and outcomes is crucial for improving patient management.
Purpose of the Study:
- To analyze the causes and mortality rates of acute gastrointestinal bleeding in elderly patients.
- To compare findings with international data.
Main Methods:
- Retrospective review of 100 consecutive elderly patients admitted with acute gastrointestinal bleeding.
- Data collected on causes of bleeding, patient demographics, and outcomes.
Main Results:
- Peptic ulcers, chronic gastritis, and gastric mucosal prolapse were common causes.
- Malignant disease accounted for 23% of cases, higher than in Western studies.
- Mortality rate for benign causes (excluding specific conditions) was 4.4%.
Conclusions:
- Benign conditions are frequent causes of acute gastrointestinal bleeding in the elderly.
- The incidence of malignancy is notable, warranting further investigation.
- Lower mortality for benign causes suggests room for improved geriatric care to reduce overall mortality.
Abstract:
One hundred consecutive patients (predominantly men, aged 60 years and older), who were admitted to the Hsinhua Hospital, Shanghai, with acute bleeding from the gastrointestinal tract during a three-year period, were reviewed. The most common causes of bleeding were peptic ulcers, chronic gastritis, prolapse of gastric mucosa, and other benign conditions. In 22 patients, bleeding was either due to oesophageal varices, or was a complication of cor pulmonale. The incidence of malignant disease was 23% (higher than that reported from the United States or the United Kingdom). The mortality rate in patients with benign causes of gastrointestinal bleeding (after exclusion of patients with malignant disease, cor pulmonale, and hepatic cirrhosis) was 4.4%--much lower than the British rate, but slightly higher than that reported in an Australian study. It is hoped that, with the increasing interest in geriatrics, and closer attention to acute bleeding from the gastrointestinal tract in the aged, the mortality rate from this condition will decline.