ELDERLY VS. YOUNG PATIENTS : CLINICAL, ENDOSCOPIC AND PROGNOSTIC PARTICULARITIES IN CASE OF UPPER GASTROINTESTINAL HEMORRHAGE : PROSPECTIVE STUDY

Aims The aim of our study is to compare the epidemiological, clinical, endoscopic, therapeutic and prognostic characteristics of UDH in young vs. elderly subjects.

Methods This is a single-center prospective cross-sectional study about 332 patients, conducted over a one-year period between June 2020 and August 2021.

We divided our patients into 2 groups, group A corresponding to subjects aged≥65 years and group B corresponding to patients<65 years.

Results Of the 332 endoscopies performed for UDH, 38.9% were older than 65 years. The sex ratio was 2.79. 31.8% of patients were on antithrombotic therapy, and 38.8% had comorbidities.

There was no statistically significant difference between the two groups regarding the origin of UDH, however there was a difference between the two groups regarding the use of antithrombotics (31, 8%vs10.8%,p<0.001) the presence of comorbidities (39.1% vs. 20.7% p<0.001) the presence of active bleeding (9.3%vs18.7%,p=0.019) and the use of endoscopic hemostasis (8.5% vs17.7%,p=0.019).

In multivariate analysis and adjusting for the studied parameters of age, sex, comorbidities, presence of active bleeding and use of antithrombotic drugs; only the presence of active bleeding could predict the need for endoscopic hemostasis (OR: 29.62,CI: 13.52-64.90,p<0.001), while the use of antithrombotic drugs and age≥65 years had no influence on this risk.

Conclusions Although older subjects had more comorbidities, more use of antithrombotics, UDH in this age group does not appear to be more severe with a lower rate of active bleeding at endoscopy implying a less frequent need for endoscopic hemostasis.

Publication History

Article published online:
14 April 2022