Predictors of Mortality in Geriatric Patients with Upper Gastrointestinal Bleeding

Background/Aims: Acute upper gastrointestinal (UGI) bleeding is a common gastrointestinal emergency and a cause of morbidity and mortality among the elderly. We aimed to evaluate demographic and epidemiological properties to identify predictors of 28-day mortality among geriatric patients diagnosed with upper GI bleeding in an emergency department(ED).
Materials and Methods: This is a retrospective study. All patients aged ≥65 years admitted to the ED and diagnosis of UGI bleeding were included in the study. Basic demographic and clinical/endoscopic findings were evaluated. The primary outcome was the identification of a 28-day mortality rate and its mortality predictors, which included ofmortality
Results: Two hundred and ninety-seven geriatric patients were included in the study. One hundred and thirty-one patients were women (44.1%); the median age of the all patients was 79 (65-98). In endoscopy, the most cause of bleeding was a gastric/duodenal ulcer in 53.9% of patients. A comparison of the patient characteristics regarding in-hospital mortality (survivor/non-survivor) revealed significant differences for chronic renal failure, hemodynamic instability, Hematocrit, blood urea nitrogen, creatinine, albumin, erythrocyte transfusion, rebleeding and Rockall scores (for all variables, p<0.05). The regression analysis revealed that low albumin and Hematocrit levels and hemodynamic instability were the independent predictors of mortality
Conclusion: Peptic ulcer bleeding is the main cause of acute UGI bleeding. Low albumin and Hematocrit levels as well as hemodynamic instability were shown to be the independent predictors of mortality. We think that, particularly patients with hemodynamic compromise at the time of hospital admission should be closely monitored and rapidly treated.