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首页> 外文期刊>World journal of gastroenterology : >Characteristics and outcomes of acute upper gastrointestinal bleeding after therapeutic endoscopy in the elderly.
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Characteristics and outcomes of acute upper gastrointestinal bleeding after therapeutic endoscopy in the elderly.

机译：老年人内镜治疗后急性上消化道出血的特征和预后。

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AIM: To characterize the effects of age on clinical presentations and endoscopic diagnoses and to determine outcomes after endoscopic therapy among patients aged >/= 65 years admitted for acute upper gastrointestinal bleeding (UGIB) compared with those aged < 65 years. METHODS: Medical records and an endoscopy data-base of 526 consecutive patients with overt UGIB ad-mitted during 2007-2009 were reviewed. The initial presentations and clinical course within 30 d after endoscopy were obtained. RESULTS: A total of 235 patients aged >/= 65 years constituted the elderly population (mean age of 74.2 +/- 6.7 years, 63% male). Compared to young patients, the elderly patients were more likely to present with melena (53% vs 30%, respectively; P < 0.001), have comorbidities (69% vs 54%, respectively; P < 0.001), and receive antiplatelet agents (39% vs 10%, respectively; P < 0.001). Interestingly, hemodynamic instability was observed less in this group (49% vs 68%, respectively; P < 0.001). Peptic ulcer was the leading cause of UGIB in the elderly patients, followed by varices and gastropathy. The elderly and young patients had a similar clinical course with regard to the utilization of endoscopic therapy, requirement for transfusion, duration of hospital stay, need for surgery [relative risk (RR), 0.31; 95% confidence interval (CI), 0.03-2.75; P = 0.26], rebleeding (RR, 1.44; 95% CI, 0.92-2.25; P = 0.11), and mortality (RR, 1.10; 95% CI, 0.57-2.11; P = 0.77). In Cox's regression analysis, hemodynamic instability at presentation, background of liver cirrhosis or disseminated malignancy, transfusion requirement, and development of rebleeding were significantly associated with 30-d mortality. CONCLUSION: Despite multiple comorbidities and the concomitant use of antiplatelets in the elderly patients, advanced age does not appear to influence adverse outcomes of acute UGIB after therapeutic endoscopy.
机译：目的：表征年龄对临床表现和内镜诊断的影响，并确定内镜治疗后≥65岁急性上消化道出血（UGIB）与<65岁患者的内镜治疗结果。方法：回顾性分析了2007年至2009年期间共收治的526例明显的UGIB患者的病历和内镜数据库。在内窥镜检查后30天内获得了最初的表现和临床过程。结果：≥≥65岁的235名患者构成了老年人口（平均年龄为74.2 +/- 6.7岁，男性为63％）。与年轻患者相比，老年患者更容易出现黑斑病（分别为53％和30％; P <0.001），合并症（分别为69％和54％; P <0.001）和接受抗血小板药物（分别为39％和10％; P <0.001）。有趣的是，在该组中观察到的血液动力学不稳定较少（分别为49％和68％; P <0.001）。消化性溃疡是老年患者UGIB的主要原因，其次是静脉曲张和胃病。在使用内窥镜治疗，输血要求，住院时间，手术需要方面，老年和青年患者的临床过程相似。[相对危险度（RR）为0.31; 95％置信区间（CI），0.03-2.75; P = 0.26]，再出血（RR，1.44; 95％CI，0.92-2.25; P = 0.11）和死亡率（RR，1.10; 95％CI，0.57-2.11; P = 0.77）。在Cox回归分析中，表现的血流动力学不稳定，肝硬化或弥漫性恶性肿瘤的背景，输血需求和再出血的发生与30天死亡率显着相关。结论：尽管老年患者存在多种合并症，并且同时使用抗血小板药物，但高龄似乎并未影响治疗性内窥镜检查后急性UGIB的不良预后。

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