Upper Digestive Hemorrhage: Clinical, Endoscopic and Evolutionary Particularities between Older and Younger Patients, Prospective Study

Upper GI bleeding is the most common reason for emergency hospitalization in hepato-gastroenterology. However, there are not enough studies comparing clinical and endoscopic features between young and elderly patients. The aim of our study is to compare the epidemiological, clinical, endoscopic, therapeutic and prognostic features of UGI in young vs. elderly subjects. Method: This is a single center prospective cross-sectional study about 332 patients, conducted over a one-year period. We divided our patients into 2 groups, group A corresponding to subjects aged ≥ 65 years and group B corresponding to patients < 65 years. Results: Among the 332 FOGD performed for HDH, 38.9% were older than 65 years. The sex ratio M/F was 2.79. 31.8% of patients were on antithrombotic therapy, and 38.8% had comorbidities. There was no statistically significant difference between the two groups A and B regarding the origin of HDH, however, it was found that there was a difference between the two groups A and B regarding the use of antithrombotic drugs (31,8%vs.10.8%, p<0.001) the presence of comorbidities (39.1%vs.20.7% p<0.001) the presence of active bleeding (9.3%vs.18.7%, p=0.019) and the use of endoscopic hemostasis (8.5%vs.17.7%, p= 0.019). In multivariate analysis and adjusting for age, sex, comorbidities, presence of active bleeding and use of antithrombotic drugs, only the presence of active bleeding could predict the need for endoscopic hemostasis. In fact, the presence of active bleeding increased the likelihood of needing endoscopic hemostasis by 29.63-fold (p<0.001), whereas the use of antithrombotics (p=0.37) and age ≥ 65 years (p=0. 21) did not influence this risk. Conclusion: Although older subjects had more comorbidities, more use of antithrombotics, HDH in this age group does not appear to be more severe with a lower rate of active bleeding at endoscopy implying a less frequent need for endoscopic hemostasis.