Clinical Spectrum and Outcomes of Acute Upper Gastrointestinal Bleeding: A Prospective Comparative Study Between Elderly and Younger Adults

TL;DR

This study compares the causes and outcomes of upper gastrointestinal bleeding in elderly and younger adults, finding that elderly patients have more severe cases and different bleeding sources.

Contribution

The study provides a prospective comparison of UGIB clinical profiles and outcomes between elderly and younger adults, emphasizing age-related differences in etiology and severity.

Findings

Elderly patients had significantly higher Rockall scores and non-variceal bleeding, while younger patients had more variceal bleeding.

Rebleeding occurred in one-third of patients, mainly from variceal sources.

Overall mortality was low at 4.3% and linked to higher Rockall scores.

Abstract

Background

Upper gastrointestinal bleeding (UGIB) is a common medical emergency with age-related variation in etiology and outcomes. This study prospectively compared the clinical profile, endoscopic findings, and outcomes of UGIB in elderly (>60 years) and non-elderly (≤60 years) patients.

Methodology

A prospective observational study was conducted at a tertiary care hospital in Pakistan between December 1, 2023, and December 31, 2025. A total of 162 patients undergoing upper gastrointestinal endoscopy were equally stratified by age. Risk stratification was performed using the Rockall score, and outcomes, including rebleeding, transfusion requirements, and in-hospital mortality, were analyzed.

Results

Elderly patients had significantly higher Rockall scores (5.87 ± 1.89 vs. 3.68 ± 2.42; p < 0.001) and predominantly non-variceal bleeding, while non-elderly patients more frequently had variceal bleeding. Rebleeding occurred in one-third of patients, predominantly from variceal sources. Overall mortality was low (4.3%) and was associated with higher Rockall scores.

Conclusions

UGIB demonstrates distinct age-related patterns in etiology and severity. Rockall-based risk stratification and timely endoscopy remain essential tools for effective, age-tailored management.

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