The etiologies of upper gastrointestinal bleeding in the elderly patients and the factors influence on prognosis

Objective :To explore the etiologies and complications of upper gastrointestinal bleeding(UGB) in the elderly patients and to investigate the influence of clinical severity on prognosis and medical cost in these patients.Methods: Clinical data of upper gastrointestinal bleeding in patients at a certain period,including 347 cases of elderly patients and 545 cases of patients in the middle age and youth,was statistically analyzed.Results:Elderly female has a higher incidence of UGB than female in the middle age and youth.As compared with the patients in the middle age and youth,the medical cost,complications and the mortality in the elderly were significantly higher.Though the elderly had a lower incidence of duodenal ulcer,complex ulcer and infection rate of helicobacter pylori than the middle-aged and young,more frequent occurrence of gastritis,gastric ulcer,gastric or pancreatic carcinoma,tumor metastasis or infiltration and bleeding of undetermined origin were observed.There was no statistical significance in the frequency of occurrence of esophageal carcinoma,liver cancer and liver cirrhosis between the elder and the middle-aged and young UGB patients.No differences were observed in distribution of age and sex between the elderly patients who survived or not,but the medical costs were much higher in patients who did not survive.A much higher death rate was observed in patients suffering from shock,diabetes and several dysfunction of heart,lung,and kidney. Conclusions: As compared with the middle-aged and young ones,the elderly UGB patients have a more frequent occurrence of gastric ulcer,gastric or pancreatic carcinoma,tumor metastasis or infiltration and bleeding of undetermined origin,a significant higher rate of complication and death,and take up more medical resource.More and much severity complications and even more occupied medical resource are observed in elderly patients who did not survive.