Gastric emergencies in older adults: not always the same old story! A tertiary care emergency department observational cohort study

BMJ Open. 2022 Jan 25;12(1):e056981. doi: 10.1136/bmjopen-2021-056981.

Abstract

Objective: To analyse and compare the clinical outcomes between patients ≥80 years and 65-79 years, who presented to our emergency department (ED) with the two most common gastric emergency (GE) clinical presentation, that is, gastric bleeding and gastric perforation.

Design: Single-centre retrospective cohort study.

Participants: A total of 1011 patients were enrolled: 421 patients aged ≥80 years were compared with a group of 590 patients aged 65-79 years.

Primary and secondary outcome measures: The primary outcome was to compare the overall mortality. Secondary outcomes included major complications, in-hospital length of stay (LOS) and need for surgical procedures.

Results: Patients ≥80 years with GE had different presentations at ED compared with younger patients: they had higher gastrointestinal bleeding (24.9% vs 16.3%, p=0.001), anemisation (14.5% vs 8.8%, p=0.005) and shock (10.9% vs 5.1%, p=0.001) rates. Median LOS, cumulative major complications and mortality rates were similar among the two groups.Multivariate analysis identified shock, gastric malignancy and gastric fistula as independent predictors for survival.

Conclusions: Patients ≥80 years with GE did not have a higher mortality rate and cumulative major complications as compared to younger elderly patients. Invasive treatments were not associated with a different prognosis in this age group.

Keywords: adult gastroenterology; adult surgery; endoscopy; surgery.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Emergencies*
  • Emergency Service, Hospital*
  • Humans
  • Length of Stay
  • Retrospective Studies
  • Tertiary Healthcare