Clinical Analysis of Elderly Patients with Acute Upper Gastrointestinal Bleeding

Background: The prevalence of acute upper gastrointestinal bleeding(AUGIB) in elderly patients has been increasing rapidly in recent years.Aims: To evaluate the etiology,clinical outcome and main risk factors of death in elderly patients with AUGIB.Methods: Three hundred and seventy-eight elderly patients with AUGIB admitted from Jan.2007 to Jan.2010 were enrolled.Patients were divided into younger group(60-80 years old,n=231) and aged group(80 years old,n=147).Basic clinical characteristics,emergency diagnosis and treatment and clinical outcome were analyzed retrospectively,and risk factors of death in aged patients were screened.Results: Co-morbidity was more common in aged group(P0.05).The main cause of bleeding was peptic ulcer in both groups.There were less patients with variceal bleeding and more patients with oesophagitis in aged group(P0.05).Rebleeding and emergency surgery were uncommon in both groups.Complications(P=0.05) and mortality(P0.05) were more common in aged group.The presence of high risk stigmata,higher blood urea nitrogen level on admission,rebleeding and severe co-morbidity were related to mortality(P0.05),and multivariate analysis showed severe co-morbidity was an independent risk factor of death in aged patients(P0.05).Conclusions: Rebleeding and emergency surgery are relatively less occurred in elderly AUGIB patients.Aged patients may have a poor prognosis,and severe co-morbidity may be the main cause of death in those patients.