Gastrointestinal bleeding in the elderly. Morbidity, mortality and cause

Area of Science:

• Gastroenterology
• Internal Medicine
• Geriatrics

Background:

• Upper gastrointestinal bleeding (UGIB) is a significant clinical challenge.
• Age-related differences in UGIB etiology and outcomes are not fully elucidated.

Purpose of the Study:

• To investigate age-specific causes and complications of upper gastrointestinal bleeding.
• To compare mortality rates across different age groups and bleeding sources.
• To assess the impact of age on surgical management decisions for UGIB.

Main Methods:

• Retrospective analysis of 136 consecutive patients with UGIB.
• Patients stratified into three age groups: young, middle-aged, and elderly.
• Evaluation of bleeding sources, complications, and mortality.

Main Results:

• Hemorrhagic gastritis was most common in young patients; gastric ulcers predominated in middle-aged and elderly groups.
• Young patients had high mortality (20%) linked to alcoholism-related liver dysfunction.
• Elderly patients had significantly higher mortality from gastric ulcers compared to young patients.
• Esophageal varices resulted in poor outcomes across all age groups.
• Mortality rates for surgically managed young and elderly patients were similar.

Conclusions:

• Age significantly influences the etiology of upper gastrointestinal bleeding.
• Gastric ulcers present a greater mortality risk in the elderly.
• Alcoholism-related complications are a major concern for younger patients with UGIB.
• Age should not preclude surgical intervention for acute gastrointestinal bleeding.