Clinical Characteristics and Outcomes of Acute Upper Gastrointestinal Bleeding in Elderly Patients: A Single-Center Study from Samutsakhon Hospital
Keywords:
upper gastrointestinal bleeding (UGIB), body mass index (BMI), gastric ulcer (GU)Abstract
Objective: To study the prevalence of acute upper gastrointestinal bleeding (acute UGIB) and the effect of age on clinical manifestations and endoscopic findings. In addition, risk factors that differed between the group aged 60 years or older and the younger group, were also investigated.
Methods: This is an observational clinical study. Data were collected from medical history, data records, together with the results of upper gastrointestinal endoscopy of acute UGIB patients admitted to the Medical Ward, Samutsakhon Hospital, from November 2024 to March 2025.
Results: Among 236 acute UGIB patients, 112 were aged 60 years or older, with a mean age of 71 ± 8.1 years, 76 patients (67.6%) were male, and the mean BMI was 24.2 ± 5.3 kilogram/meter2 When compared with the group younger than 60 years, the symptoms at hospital admission were hematemesis (21.4% vs 42.9%; p = .001) and coffee ground vomiting (39.2% vs 24.3%; p = .013), respectively. The most common clinical sign was pulse rate more than 100 beats per minute (30.3% vs 45.4%; p = .020). In addition, it was found that the most common comorbidity was hypertension (72.1% vs 21.9%; p < .001), followed by hyperlipidemia (43.6% vs 10.5%; p < .001), and diabetes (40.9% vs 17; p < 0.001). Moreover, there was a history of smoking (28.5% vs 54.3%; p < .001), a history of drinking alcohol (36.5% vs 68%; p < .001), a history of taking aspirin (24% vs 1.6%; p < .001), and a history of taking warfarin (5.3% vs 0%; p = .009), respectively. The results of upper gastrointestinal endoscopy showed that gastritis was the most common (91.7% vs 85.9%; p = .119), followed by, gastric ulcer (49% vs 34.8%; p = .025) and esophageal aneurysm (6.2% vs 22.7%; p < .001). About the outcomes at follow-ups of UGIB treatment, rebleeding at 7 days was found 3.6% vs 1.6% (p = .341) and 30-day mortality 6.2% vs 0.8% (p = .021), respectively.
Conclusion: In the elderly group, having comorbidities and history of taking various medications directly affects the chance of UGIB, which may be an important cause of the higher mortality rate than in the younger group. However, if treatment with endoscopy and other factors are well controlled, it should result in better outcomes.
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