Nonvariceal upper gastrointestinal bleeding in elderly people: <scp>C</scp>linical outcomes and prognostic factors

González-González, J.A.; Monreal-Robles, Roberto; García-Compeán, Diego; Paz-Delgadillo, Jonathan; Wah-Suárez, Martín; Garza, Héctor J. Maldonado

doi:10.1111/1751-2980.12459

Cited by 17 publications

(13 citation statements)

References 28 publications

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“…[1] The incidence of NVUGIH is 20-60/100,000 people, [2–4] and is particularly high among elderly patients who carry other types of systemic diseases; the mortality rate in these patients is about 7% to 14%. [5] The prognosis of upper gastrointestinal bleeding may vary from mild to life- threatening. [4] Patients with mild bleeding might fully recover without specific clinical treatment, while those with severe bleeding may experience severe complication and even death if they do not receive the treatment for the condition.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Glasgow-Blatchford and Rockall Scores for prediction of nonvariceal upper gastrointestinal bleeding outcomes in Chinese patients

et al. 2019

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Section: Introductionmentioning

confidence: 99%

Comparison of the Glasgow-Blatchford and Rockall Scores for prediction of nonvariceal upper gastrointestinal bleeding outcomes in Chinese patients

et al. 2019

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“…As in Western populations, the proportion of elderly people in Turkey has increased (1). As life expectancy has increased, so have the comorbidities and the use of medications such as acetylsalicylic acid, nonsteroidal anti-inflammatory drugs (NSAIDs), and oral anticoagulants (2). Despite the decline in incidence of NVUGB and the advances in diagnostic procedures, resuscitation, medical and endoscopic treatment, and intensive care, the rate of mortality remains unchanged (3).…”

Section: Introductionmentioning

confidence: 99%

Changing patterns of upper gastrointestinal bleeding over 23 years in Turkey

Danış

Teki̇n

Akarca

et al. 2019

Turk J Gastroenterol

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Background/Aims: This study aimed to compare the causes of nonvariceal upper gastrointestinal bleeding (NVUGB), demographics, risk factors, and outcomes of patients during two periods between 1993 and 2016 in a tertiary health-care center in Turkey. Materials and Methods: We compared the causes of NVUGB and clinical outcomes in 421 patients hospitalized between January 1993 and December 1995 with those of 231 patients with NVUGB hospitalized between January 2015 and September 2016. We also compared epidemiological characteristics, risk factors, and the rates of endoscopic hemostatic procedures. Results: We observed significant increases in patients' mean age, in the percentage of patients with comorbid conditions, and in the percentage of patients who received direct-acting oral anticoagulants before bleeding. We also observed a statistically nonsignificant increase in the diagnoses of gastric ulcer, along with a significant concordant decrease in diagnoses of duodenal ulcer as a cause of bleeding. The use of emergency surgical hemostasis decreased among cases of peptic ulcer bleeding. The overall rate of mortality from bleeding did not significantly change between the two periods. Conclusion: Over the 23 years studied, the causes of NVUGB changed, probably because the population was increasingly elderly population and because of the use of anticoagulants and better therapeutic approaches to chronic duodenal ulcers. The use of emergency surgical hemostasis reduced, but mortality rate did not significantly change between the two specific periods.

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“…The usefulness of the albumin level has also been verified in the context of the management of gastrointestinal bleeding patients. Gonzalez-Gonzalez et al reported a correlation ( p = 0.001, OR 5.230, 95% CI 2.099–13.029) with the prognosis of serum albumin values in elderly peptic ulcer patients; thus, the albumin level may be useful as a prognostic marker [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of various risk scores for the prognosis of hemorrhagic upper gastrointestinal mucosal disorder

et al. 2020

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Background: Various risk scores have been proposed that are useful for the management of upper gastrointestinal bleeding (UGIB), which is an important disease in emergency medicine. Few studies have examined the usefulness of Charlson Comorbidity index (CCI) in this disease, which evaluates the patient's general condition by scoring the patient's underlying disease. There have been no studies investigating the efficacy of CCI compared to other risk scores in the management of UGIB requiring endoscopic hemostasis. Methods: In addition to the Glasgow-Blatchford score, AIMS65 score, and Rockall score, we investigated the efficacy of the outcome prediction obtained by the original CCI and the updated CCI, scored only with respect to the underlying disease. We also examined the cutoff value when using the risk score. This retrospective study included 265 patients with hemorrhagic upper gastrointestinal mucosal lesions who underwent emergency endoscopic hemostasis during a 6-year period between 2011 and 2016 in our hospital. Results: The updated CCI and AIMS65 score correlated with prognosis in multivariate analysis (p = 0.002 and p = 0.003, respectively). In clinical practice, the prognosis might be worse if both updated CCI and AIMS65 score were 3 point or more. Conclusion: In addition to the AIMS65 score, the updated CCI can be a useful tool for managing upper gastrointestinal mucosal disorder bleeding that requires endoscopic hemostasis.

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Nonvariceal upper gastrointestinal bleeding in elderly people: Clinical outcomes and prognostic factors

Abstract: Clinical evolution and mortality do not differ between the elderly and younger patients with acute nonvariceal UGIB. Serum albumin level at admission is a prognostic marker for mortality in elder patients.

Cited by 17 publications

References 28 publications

Comparison of the Glasgow-Blatchford and Rockall Scores for prediction of nonvariceal upper gastrointestinal bleeding outcomes in Chinese patients

Comparison of the Glasgow-Blatchford and Rockall Scores for prediction of nonvariceal upper gastrointestinal bleeding outcomes in Chinese patients

Changing patterns of upper gastrointestinal bleeding over 23 years in Turkey

Comparison of various risk scores for the prognosis of hemorrhagic upper gastrointestinal mucosal disorder

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