Acute upper gastrointestinal bleeding in Italy: preliminary results of patient characteristics, source of bleeding and clinical outcomes

R. Marmo*, […] A. Maringhini […]

Digestive and Liver Disease 2015 Volume 47, Supplement 2,

Pages 69-220


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.

Keywords: Adverse outcomes, Elderly, Therapeutic end-oscopy, Upper gastrointestinal bleeding

Link PubMed

Altre pubblicazioni

Alberto Maringhini
Direttore Medicina Interna 1
ARNAS Civico
Research gate score
  • Research Interests: 996.7
  • Citations: 1.973
  • h-index: 26
Screening del cancro del pancreas: un trial controllato
Coordinatori dello studio
  • Dott. Alberto Maringhini
  • Dott.ssa Rosalia Patti
  • Dott.ssa Anna Riili
  • Dott.ssa Margherita Rossi
Scopo dello studio

dimostrare che lo screening di una popolazione a rischio per cancro del pancreas permette:

  • diagnosi precoce
  • migliore sopravvivenza


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