The Quarterly journal of medicine
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We report a series of 103 admissions of patients aged 80 years or more with acute upper gastrointestinal haemorrhage to one hospital over a four-year period. A cause was eventually found during 81.5 per cent of admissions and of these, 57 per cent had bled from chronic peptic ulcers. After 64 per cent of admissions, the patient received a blood transfusion and in 25 per cent, the blood transfusion exceeded 5 units. ⋯ Patients who died from haemorrhage, when compared to all others, were more likely to have bled from a peptic ulcer and to have significant co-existing disease, to have ingested non-steroidal antiinflammatory drugs or aspirin before admission, to have raised blood urea level and low systolic blood pressure at admission and to have required blood transfusion of more than 5 units. Our study has shown that upper gastrointestinal haemorrhage secondary to peptic ulceration is a serious and often fatal condition in the elderly. Identification and effective monitoring of those at particular risk of death may be essential if mortality is to be reduced.