ETIOLOGIC AND EVOLUTIONARY ASPECTS OF UPPER GASTROINTESTINAL BLINDING IN THE ELDERLY

Aims:

The aim of our work is to study the epidemiological characteristics of upper gastrointestinal blinding in the elderly.

Methods:

A retrospective study and a prospective (from March 2015 to March 2017) descriptive and analytical study, combining 266 We compared two groups G1 (n = 142) and G2 (n = 121) aged respectively:> or equal to 60 years and < to 60 years.

Results:

Our population comprised 142 patients over the age of 60 years (53.38%), with an average age of 75 years (60 – 96 years), with a sex ratio of 1.7. Elderly subjects were characterized by a higher frequency of associated comorbidities compared to group G2, including: known heart disease (19.7% vs. 5.7% in group G2, P: 0.001), and frequent NSAID use (36.6% vs. 20.6% 23% vs. 11.5%, P = 0.010) and Clopidogrel (4.2% vs. 0%, p = 0.024). The main causes of bleeding in the elderly were: rupture of oesophageal varices in 19.7% cases, ulcer disease in 48%, oesophagitis in 17%, angiodysplasia in 4.9%, Gastric tumor in 4.9% cases and a bulb duodenitis in 3.5% the cases. The difference in etiologies was statistically significant between the two groups, notably more rupture of oesophageal varices in young (p = 0.043) and more vascular lesions in elderly subjects (p = 0.003), with a difference that was not significant (P = NS) and other less frequent aetiologies. There was no statistically significant difference between the rate of recurrent bleeding and the mortality rate between the two groups with 2.8% vs. 2.5 p = NS, 2.11 vs. 02.4 p = NS.

Conclusions:

Upper gastrointestinal bleeding in the elderly is characterized by a lower rate of rupture of esophageal varices and a higher rate of vascular lesions.