# 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.

## Key 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.