PMID- 15906766
OWN - NLM
STAT- MEDLINE
DCOM- 20050609
LR  - 20190721
IS  - 0163-2116 (Print)
IS  - 0163-2116 (Linking)
VI  - 50
IP  - 5
DP  - 2005 May
TI  - Acute lower gastrointestinal hemorrhages in geriatric patients.
PG  - 898-904
AB  - Age is a risk factor in acute lower gastrointestinal hemorrhages (LGIH). The 
      objectives here were to analyze: (1) diagnostic and therapeutic handling, (2) 
      related morbidity and mortality, (3) the indications for surgery, and (4) the 
      evolution of acute LGIH in patients > or =80 years. Forty-three patients >80 
      years with acute LGIH were reviewed retrospectively. In 86% (n = 37) related 
      comorbidities were found, in 9% (n = 4) there had been prior colorectal surgery, 
      19% (n = 8) were antiaggregated, and 7% (n = 3) were anticoagulated. One hundred 
      thirty-two cases of acute LGIH in patients <80 years were used as a control 
      group. Student's t test and the chi-square test were applied. On arrival at the 
      emergency ward 11 cases (26%) had hemodynamic instability and 8 of these were 
      stabilized using conservative measures. In 39 cases an endoscopy was performed, 
      allowing for an etiological diagnosis in 59% (n = 23) of cases, above all in 
      those carried out in an urgent or semiurgent way. The arteriography permitted an 
      etiological diagnosis in two of the four cases in which it was carried out. In 
      seven patients (16%) urgent surgery was indicated: three were hemorrhoidectomies, 
      three were subtotal colectomies, and one was a resection of the small intestine. 
      The morbidity rate was 10% (n = 4) in the patients who were not treated and 14% 
      (n = 1) in those treated, with a mortality rate of 8% (n = 3) and 14% (n = 1), 
      respectively. The rate of relapse of bleeding after discharge from hospital was 
      42% (n = 18), with nine of these needing to be readmitted into hospital. In 
      comparison with the control group, they present a different bleeding etiology 
      (diverticulosis as opposed to the benign anal-rectal and small intestinal 
      pathology in the younger population; P = 0.017), surgery is indicated with less 
      frequency (9 versus 33%; P = 0.007), and there is a higher relapse rate (42 
      versus 26%; P = 0.045). Acute LGIH in geriatric patients relents in most cases 
      with the use of conservative measures, although there is a high percentage of 
      related morbidity and mortality, and of relapse of bleeding.
FAU - Rios, Antonio
AU  - Rios A
AD  - Servicio de Cirugia General y Digestivo I, Departamento de Cirugia, Unidad de 
      Endoscopias, Hospital Universitario Virgen de la Arrixaca, El Palmar 30120, 
      Murcia. ARZRIOS@teleline.es
FAU - Montoya, Mariano J
AU  - Montoya MJ
FAU - Rodriguez, Jose Manuel
AU  - Rodriguez JM
FAU - Serrano, Andres
AU  - Serrano A
FAU - Molina, Joaquin
AU  - Molina J
FAU - Parrilla, Pascual
AU  - Parrilla P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
SB  - IM
MH  - Acute Disease
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Gastrointestinal Hemorrhage/*diagnosis/mortality/*surgery
MH  - Hospital Mortality
MH  - Humans
MH  - Lower Gastrointestinal Tract
MH  - Male
MH  - Patient Selection
MH  - Prognosis
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2005/05/24 09:00
MHDA- 2005/06/10 09:00
CRDT- 2005/05/24 09:00
PHST- 2005/05/24 09:00 [pubmed]
PHST- 2005/06/10 09:00 [medline]
PHST- 2005/05/24 09:00 [entrez]
AID - 10.1007/s10620-005-2662-1 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2005 May;50(5):898-904. doi: 10.1007/s10620-005-2662-1.