The percentage of older patients suffering from AUGIB has been increasing rapidly over the last years in the Western World. Elderly patients constitute a subgroup with special characteristics, which need careful handling during their hospitalization, because it is a population with considerable co-morbidity, higher medication use and greater risk for further complications. There has been limited information on the clinical outcome of the very elderly patients with AUGIB.
A clinical article published on 7 July 2008, in the World Journal of Gastroenterology addresses this issue. The research team led by Prof. Nikolopoulou VN, Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Greece reviewed the records of 147 patients over 80 years old who hospitalized with AUGIB. They found that severity of bleeding in octogenarians is not different in comparison with younger patients, rebleeding is uncommon and the need for emergency surgical hemostasis rare. Mortality is higher than the younger population and the presence of severe comorbidity is the main adverse factor of clinical outcome.
These results show that very old patients suffering from AUGIB should be managed as younger patients, but clinicians should have in mind that their patients with severe comorbidity are at increased risk of adverse outcome.