Factors predicting mortality of elderly patients with acute upper gastrointestinal bleeding
Article Category: Original article
Published Online: Jan 31, 2017
Page range: 115 - 122
DOI: https://doi.org/10.5372/1905-7415.1002.471
Keywords
© 2016 Thirada Thongbai, Kessarin Thanapirom, Wiriyaporn Ridtitid, Rungsun Rerknimitr, Rattikorn Thungsuk, Phadet Noophun, Chatchawan Wongjitrat, Somchai Luangjaru, Padet Vedkijkul, Comson Lertkupinit, Swangphong Poonsab, Thawee Ratanachu-ek, Piyathida Hansomburana, Bubpha Pornthisarn, Varocha Mahachai, Sombat Treeprasertsuk
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Acute upper gastrointestinal bleeding (UGIB) is a common gastrointestinal disease emergency and a cause of morbidity and mortality.
Objectives
To assess the clinical outcomes and explore predictive factors for mortality of elderly patients with acute UGIB.
Methods
During the study period from January 2010 to September 2011, we prospectively enrolled 981 patients presenting with UGIB from 11 hospitals (mean age ± standard deviation (SD), 59.4 ± 14.9 years; range, 17–94 years; including 661 men). Of these 981 patients, 499 (50.9%) were elderly. Basic demographic data and clinical findings, and Rockall scores were collected and calculated.
Results
We studied 499 elderly patients. Their mean age ± SD was 71.63 ± 7.65 years. The 30-day mortality rate was 9% and rebleeding was just 1%. Regression analysis showed a pulse rate >100 beats per min at first visit, red blood in a nasogastric aspiration, comorbidity with coronary artery disease, and creatinine >1.5 mg/dL were independent predictive factors of 30-day mortality.
Conclusions
Peptic ulcer bleeding is a major cause of acute UGBI in the elderly. We recommend patients with predictive factors of mortality, pulse rate >100 beats per min at first visit, red blood in nasogastric aspiration, comorbidity with coronary artery disease, and creatinine >1.5 mg/dL be closely monitored and treated promptly. Reducing mortality from peptic ulcer bleeding should focus on preventing peptic ulcer occurrence as a result of ulcerogenic medications.