Elsebaey Mohamed A, Elashry Heba, Elbedewy Tamer A, Elhadidy Ahmed A, Esheba Noha E, Ezat Sherif, Negm Manal Saad, Abo-Amer Yousry Esam-Eldin, Abgeegy Mohamed El, Elsergany Heba Fadl, Mansour Loai, Abd-Elsalam Sherief
Internal Medicine Department Tropical Medicine Department, Tanta University Mahalla Hepatology Teaching Hospital, Elgharbia National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Medicine (Baltimore). 2018 Apr;97(16):e0403. doi: 10.1097/MD.0000000000010403.
Acute upper gastrointestinal bleeding (UGIB) affects large number of elderly with high rates of morbidity and mortality. Early identification and management of the factors predicting in-hospital mortality might decrease mortality. This study was conducted to identify the causes of acute UGIB and the predictors of in-hospital mortality in elderly Egyptian patients.286 elderly patients with acute UGIB were divided into: bleeding variceal group (161 patients) and bleeding nonvariceal group (125 patients). Patients' monitoring was done during hospitalization to identify the risk factors that might predict in-hospital mortality in elderly.Variceal bleeding was the most common cause of acute UGIB in elderly Egyptian patients. In-hospital mortality rate was 8.74%. Increasing age, hemodynamic instability at presentation, co-morbidities (especially liver cirrhosis associated with other co-morbidity) and failure to control bleeding were the predictors of in-hospital mortality.Increasing age, hemodynamic instability at presentation, co-morbidities (especially liver cirrhosis associated with other co-morbidity) and failure to control bleeding should be considered when triaging those patients for immediate resuscitation, close observation, and early treatment.
急性上消化道出血（UGIB）影响大量老年人，其发病率和死亡率很高。早期识别和处理预测住院死亡率的因素可能会降低死亡率。本研究旨在确定埃及老年患者急性UGIB的病因及住院死亡率的预测因素。286例急性UGIB老年患者被分为：静脉曲张出血组（161例患者）和非静脉曲张出血组（125例患者）。住院期间对患者进行监测，以确定可能预测老年患者住院死亡率的危险因素。静脉曲张出血是埃及老年患者急性UGIB最常见的病因。住院死亡率为8.74%。年龄增加、就诊时血流动力学不稳定、合并症（尤其是与其他合并症相关的肝硬化）以及出血未能得到控制是住院死亡率的预测因素。在对这些患者进行分诊以便立即复苏、密切观察和早期治疗时，应考虑年龄增加、就诊时血流动力学不稳定、合并症（尤其是与其他合并症相关的肝硬化）以及出血未能得到控制等因素。
