- 作者：Nabil Ben Chaabane ; nabilca@yahoo.fr ; Hedi Ben Youssef ; Hichem Loghmeri ; Olfa Helara ; Wissem Melki ; Fethia Bdioui ; Leila Safer ; Hamouda Saffar
- 刊名：Arab Journal of Gastroenterology
- 出版年：2011
- 出版时间：September 2011
- 年：2011
- 卷：12
- 期：3
- 页码：158-161
- 全文大小：169 K
Background and study aims
The older age group presents a major problem in the management of acute gastrointestinal bleeding with a relatively high mortality. The study aims to describe the background characteristics, causes and outcome of acute upper gastrointestinal bleeding in the elderly in Tunisia.Patients and methods
We retrospectively reviewed data of 401 patients aged ?#xA0;60 years presenting with upper gastrointestinal bleeding. Information collected included history, physical examination findings, laboratory data, endoscopic findings and length of hospital stay. Patients were divided into two groups: group A (65?9 years) and group B (>79 years).
Results
Group A included 315 patients and group B 86 patients. There was a male preponderance in both groups. Co-morbidity (p < 0.01) and use of non-steroidal anti-inflammatory drugs (NSAIDs) or anti-platelet drugs (p < 0.01) were more common in group B. Oesophagitis was the cause of bleeding in 38.37 % in group B, as compared with 19 % in group A. The main cause of bleeding in group A was peptic ulcer. Rebleeding (6/86) and emergency surgery (1/86) were rare in group B and not different from those in group A. However, the bleeding-related mortality in the very elderly group was higher (13.9 % vs. 4.76 % ; p = 0.02).
In multivariate analysis, only shock on admission was independently related to mortality (p = 0.02).
Conclusion
Oesophagitis is the major cause of upper gastrointestinal haemorrhage in the very elderly patients. While rebleeding and emergency surgery rates are relatively low, the bleeding-related mortality was higher in the very elderly group.