Upper gastrointestinal bleeding in octogenarians: a prospective comparative study on clinical, endoscopic findings and outcomes with younger patients

Yıl 2023, Cilt: 4 Sayı: 5, 535 - 541, 27.10.2023

Muhammed Bahaddin Durak , Cem Şimşek , Yavuz Çağır , İlhami Yüksel

https://doi.org/10.47582/jompac.1341805

Öz

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.

Anahtar Kelimeler

Nonvariceal upper gastrointestinal bleeding, octogenarian, rebleeding, 30-day mortality.

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

Öz

Amaç: Akut üst gastrointestinal kanama, ilerleyen yaşla birlikte daha yaygın hale gelen kritik bir tıbbi acil durumdur. Bu çalışma, UGIB ile başvuran 80 yaşın altındaki hastalar ile seksen yaş üzeri hastalar arasındaki klinik ve endoskopik özelliklerin yanı sıra klinik sonuçları karşılaştırmayı amaçladı.
Yöntemler: Geçmiş tıbbi öykü, fizik muayene, laboratuvar ve endoskopik bulgulara ilişkin veriler prospektif olarak toplandı. Klinik sonuçlar şunları içermektedir: (1) Endoskopik tedavi ihtiyacı; (2) Kan transfüzyon gereksinimi; (3) Hastanede kalış süresi; (4) Tekrar kanama olayları; ve (5) 30 günlük mortalite oranı.
Bulgular: Çalışma, kardiyovasküler hastalıklar, kronik böbrek yetmezliği ve hipertansiyon gibi komorbiditelerin seksenli yaşlarda istatistiksel olarak daha yaygın olduğunu ortaya koydu. Ayrıca, seksenli yaşlarda daha düşük serum albümin ve hemoglobin seviyelerine ve daha yüksek INR ve BUN seviyelerine sahipti. Risk skorlama sistemlerine göre yüksek risk sınıflandırması, seksen yaşlarında olanlar arasında önemli ölçüde daha yaygındı. Klinik sonuçları değerlendirildiğinde, seksen yaşındakiler daha uzun hastanede yatış süresi, daha yüksek transfüzyon ihtiyacı ve daha yüksek 30 günlük mortalite oranı saptandı. Peptik ülser her iki grupta da en yaygın kanama nedeni olarak belirlendi, ancak gastrik ülserleri istatistiksel olarak seksen yaşlarında daha yaygındı.
Sonuçlar: Akut üst gastrointestinal kanamanın şiddeti, daha fazla komorbid hastalık, daha düşük serum albümin, hemoglobin seviyeleri ve daha yüksek INR, BUN seviyelerinde ve ayrıca Yüksek riskli puanlama sistemleri nedeniyle seksenli yaşlarda gençlere göre belirgin şekilde artmıştır. Mide ülserleri seksen yaşlarında istatistiksel olarak daha yaygındı.

Anahtar Kelimeler

Varis dışı üst gastrointestinal kanama, seksenli yaşlar, tekrar kanama, 30 günlük mortalite

Kaynakça

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