CLINICAL CHARACTERISTICS, SEVERITY, AND OUTCOME OF ACUTE UPPER GASTROINTESTINAL BLEEDING IN ELDERLY AND NON-ELDERLY PATIENTS IN A TERTIARY CARE HOSPITAL- A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Introduction: Upper gastrointestinal bleeding (UGIB) is a common emergency that requires hospitalization, and is more prevalent in men and older individuals. Age and co-morbidities are important factors for high mortality in UGIB patients, and elderly patients have an increased risk of mortality and morbidity compared to younger individuals. The type of UGIB experienced can also vary based on age. The Aim and objectives: aim of this study was to examine and compare the clinical characteristics, severity, and outcome of UGIB in elderly individuals (aged 60 or older) and non-elderly individuals (aged under 60) in Assam, India. Materials And Methods: This was a prospective observational study conducted at Assam Medical College and Hospital between April 2022 and September 2022. The study included adult patients presenting with UGIB. Patients below 18 years of age and in-patients who developed UGIB during hospitalization were excluded. A diagnosis of UGIB was based on the history of hematemesis and/or melena. Relevant blood and radiological investigations were conducted for all patients. All patients underwent upper GI endoscopy (UGIE). Data on clinical proles, laboratory reports, transfused blood/blood products, endoscopic ndings and interventions, and subsequent outcomes were collected prospectively for analysis. Results And Discussion: A total of 60 patients were included in the study, with a mean age of 42 years and 78.33% of patients being male. Of the 60 patients, 70% were non-elderly and 30% were elderly. The proportion of patients with co-morbidities and the use of non-steroidal anti-inammatory drugs or oral anti-coagulants was higher in the elderly group. The commonest mode of presentation among non-elderly patients was isolated melena (55%), while haematemesis in association with melaena was more common among elderly patients (50%). The proportion of patients with tachycardia and hypotension was signicantly higher among the elderly group. Variceal bleeding was signicantly higher among the elderly group (50% vs. 25%). The Rockall score, a measure of the severity of UGIB, was higher in 25% of elderly patients compared to 12