Acute Upper Gastrointestinal Bleeding: Less Severe Bleeding In More Frail and Older Patients. Comparison Between Two Periods Fifteen Years Apart

Aims Acute upper gastrointestinal bleeding (AUGIB) remains a common medical emergency with considerable morbidity and mortality. The aim of this study was to compare characteristics of patients presented with AUGIB today with those of patients15 years ago.

Methods Data from 225 patients admitted with AUGIB in our hospital in 2019 were compared with retrospectively collected data from 238 patients hospitalized with AUGIB at the same hospital 15 years ago (2004).

Results Mean age of patients increased from 66.1±16.1 years to 69.6±15.3 (p = 0.016), more patients had coexisting diseases [190/225, 84,5 % vs 174/238, 73.1 %, p = 0.01 (especially cardiovascular 138/225, 61.3 % vs 118/238, 49.6 % p = 0.02)], were inpatients at onset of bleeding (20/225, 8.9 % vs 9/238, 3.9 %, p = 0.023), were under anticoagulants (42/225, 18.7 % vs 14/238, 5.9 %, p = 0.0001) but less under salospir ± clopidogrel (76/225, 33.7 % vs 88/238, 37 %), Charlson Comorbidity Index was higher nowadays (5.6±6.4 vs 3.4±2.3, p = 0.01). A peptic ulcer was less frequently cause of bleeding (88/225, 39.1 % vs 136/238, 57.1 %, p = 0.005) while more often nowadays endoscopy was negative (20/225, 8.9 % vs 9/238, 3.8 %, p = 0.023). In peptic ulcer bleeding patients active bleeding on endoscopy was less frequent [5/88, 5.7 % vs 22/136, 16.8 %, p = 0.01 (Ia: 0/88 vs 8/136)]. Also fewer patients had stigmata of recent bleeding required hemostasis (31/88 vs 72/136, p = 0.004) and more patients were without stigmata of recent hemorrhage 44/88 (50 % vs 47/131, 35.9 %, p = 0.04). and more patients were without stigmata of recent hemorrhage 44/88 (50 % vs 47/131, 35.9 %, p = 0.04).The rate of rebleeding statistically decreased (from 20/238, 8.4 % to 9/225, 4 %, p = 0.02) while overall mortality remained unchanged (14/238, 5.9 % vs 11/225, 4.9 %).

Conclusions AUGIB episodes nowadays are less severe with less peptic ulcer bleeding but the patients are older and with more comorbidities.

Citation: Diamantopoulou G, Tsounis E, Papantoniou K et al. eP89 ACUTE UPPER GASTROINTESTINAL BLEEDING: LESS SEVERE BLEEDING IN MORE FRAIL AND OLDER PATIENTS. COMPARISON BETWEEN TWO PERIODS FIFTEEN YEARS APART. Endoscopy 2021; 53: S125.

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Artikel online veröffentlicht:
19. März 2021