Seksen yaş üstü hastalarda üst gastrointestinal kanama: daha genç hastalarla klinik, endoskopik bulgular ve sonuçlar üzerine prospektif karşılaştırmalı bir çalışma

Abstract

Background: Acute upper gastrointestinal bleeding (UGIB) is a critical medical emergency that becomes more prevalent with advancing age. This study aimed to compare clinical and endoscopic features, as well as clinical outcomes, between patients below 80 years of age and octogenarians (80 years of age) presenting with UGIB.
 Methods: Data related to past medical history, physical examination, laboratory, and endoscopic findings were collected prospectively. The clinical outcomes evaluated in both octogenarian and younger groups included: (1) necessity for endoscopic intervention; (2) transfusion requirement; (3) hospital stay duration; (4) rebleeding events; and (5) 30-day mortality rate.
 Results: The study revealed that comorbidities such as cardiovascular diseases, chronic renal failure, and hypertension were statistically more prevalent in octogenarians. Furthermore, octogenarians had lower serum albumin and hemoglobin levels and higher INR and BUN levels. High-risk categorization, according to risk scoring systems, was significantly more prevalent among octogenarians. Upon evaluating clinical outcomes, octogenarians demonstrated a longer hospital stay, higher transfusion needs, and a higher 30-day mortality rate. Peptic ulcers were identified as the most common cause of bleeding in both groups, but gastric ulcers were statistically more common in octogenarians.
 Conclusions: The severity of UGIB is notably increased in octogenarians than in younger people because of more comorbid disease, lower serum albumin hemoglobin levels, higher INR BUN, and high-risk scoring systems. Gastric ulcers were statistically more common in octogenarians.