[Comparison of treatment outcome for non-variceal upper gastrointestinal hemorrhage using endoscopic obliteration methods and traditional methods in patients over 60]

Authors present results of therapy of patients over 60 treated because of nonvariceal upper gastrointestinal bleeding in General Surgery Department in Oświecim. In 1991-1993 47 patients underwent non-endoscopic therapy. In 1994-1996 endoscopic obliteration with 0.01% epinephrine or 1% polidocanol in patients over 60 was applied. In the group over 60 more often concomitant diseases (cardiovascular, diabetes, atherosclerosis) were noted. Similar endoscopic obliteration efficacy (90% vs. 91%) in patients aged under and over 60 was observed. Patients treated with endoscopic obliteration underwent urgent operation twice rarely then conservative management (6.7% vs. 13%). They obtained less quantity of blood (2.23 vs. 3.4 unit). Their hospital stay was shorter (9 vs. 13 days). In both kind of therapy, mortality in patients over 60 was higher then under 60, but less often in group undergone endoscopic obliteration (traditional treatment 28% vs. 6%, endoscopic 15% vs. 2%).

1. Reason of worse therapy results of upper gastrointestinal bleeding among patients aged over 60 was great number of concomitant diseases. 2. Efficacy of endoscopic obliteration 0.01% epinephrine and 1% polidocanol was independent from age. 3. Application of endoscopic obliteration improved results of therapy in patients aged over 60.