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- Title
Clinical and Endoscopic profile of geriatric patients with upper gastrointestinal bleeding at a tertiary care centre.
- Authors
Upadhyaya, Susmita; Pathania, Monika; Dhar, Minakshi; Upadhyaya, Ashutosh
- Abstract
Background: This study was undertaken to address the clinical profile, endoscopic profile, and outcomes in geriatric patients with UGIB at a tertiary care centre in the northern India. Methods: A descriptive prospective study was conducted in AIIMS, Rishikesh from 8th August 2022 to 30th April 2023 after obtaining ethical clearance from Institutional Ethics Committee. This study involved all the geriatric patients who presented with UGIB, met inclusion criteria, and consented to participate. A total of 71 patients were enrolled. The study aimed to predict the prognosis/mortality of the patients using Rockall score and observe the outcomes in the form of death or discharge during the hospital stay. Statistical analyses were performed with statistical software (SPSS). Results: Most patients (42%) were in the age group 60-65 years. Smoking, alcohol intake, hypertension, diabetes mellitus, cirrhosis, thrombocytopenia, anemia, NSAIDs use, and antiplatelet use were seen in 66%, 35%, 56%, 46.5%, 43.6%, 49%, 80%, 35%, and 39% respectively. In this study, 70(98.6%) presented with Malena, 48(67.6%) with hematemesis, 13 (18.3%) with hematochezia. Varices were the most frequent cause of UGIB (44%) in our study followed by peptic ulcer disease (38%) and neoplasm (18%). Of the total, 49(69%) were discharged and 22 (31%) died in the hospital. Mean age of patients who died was 70.8 while those who were discharged was 66.4. Odds ratio (OR) of mortality in patient with hematemesis was 4.368 (CI 1.139-16.753, p 0.032), hematochezia was 7.78 (CI 2.061-29.439, p 0.002), rebleeding was 1.823 (CI 0.648-5.214, p 0.255), and family history of UGIB was 4.271 (CI 1.379-13.228, p 0.012). The mean Rockall score amongst patient who died was 8.7 while the same for the patients who were discharged was 5.7. Conclusion: Clinical profiles like hematemesis and rebleeding were found to be associated with poor outcomes. Similarly, endoscopic profiles like varices and neoplasm were also found to be associated with poor outcomes. Overall, higher Rockall scores were also identified as risk factors for poor outcomes. Identifying these predictors can aid in risk stratification and better management of patients with UGIB. However, further research and larger studies may be required to validate and generalize these findings.
- Subjects
RISHIKESH (India); INDIA; GASTROINTESTINAL hemorrhage; TERTIARY care; PEPTIC ulcer; HEMATEMESIS; STATISTICAL software; AGE groups
- Publication
Journal of the Indian Academy of Geriatrics, 2023, Vol 19, Issue 3, p167
- ISSN
0974-3405
- Publication type
Abstract