Predictors of Mortality in Geriatric Patients with Upper Gastrointestinal Bleeding

Abstract

Aim:Acute upper gastrointestinal (UGI) bleeding is a common gastrointestinal emergency and a cause of morbidity and mortality among the elderly. We aimed to evaluate the demographic and epidemiological characteristics of geriatric patients diagnosed with UGI bleeding in an emergency department (ED) to determine the predictors of 28-day mortality among them.Materials and Methods:All patients aged ≥65 years admitted to ED and diagnosed with UGI bleeding were included in this retrospective study. Baseline demographic and clinical/endoscopic findings were evaluated. The primary outcome was 28-day mortality rate and its predictors, which among geriatric patients diagnosed with UGI bleeding in an ED.Results:In total, 297 geriatric patients were included in the study; of them, 131 were women (44.1%). The median patient age was 79 (65-98) years. During endoscopy, the most common cause of bleeding was a gastric/duodenal ulcer (53.9% patients). A comparison of the patient characteristics in terms of in-hospital mortality (survivor/non-survivor) revealed significant differences in chronic renal failure; hemodynamic instability; hematocrit values; blood urea nitrogen, creatinine, and albumin levels; erythrocyte transfusion; rebleeding; and Rockall scores (for all variables, p<0.05). The regression analysis revealed that low albumin levels and hematocrit values as well as hemodynamic instability were the independent predictors of mortality.Conclusion:Peptic ulcer bleeding is the main cause of acute UGI bleeding. Low albumin levels and hematocrit values as well as hemodynamic instability are the independent predictors of mortality. We believe that geriatric patients with UGI, particularly those with hemodynamic compromise at the time of hospital admission, should be closely monitored and promptly treated.

Keywords

• geriatric
• upper gastrointestinal bleeding
• mortality