Clinical Characteristics of Older Patients With Upper Gastrointestinal Bleeding and Analysis of Factors Associated With Shock

XU Changqin; QIN Weiqiang; WU Na; ZENG Guoqiong; YI Xiaoling

doi:10.13919/j.issn.2095-6274.ZHJY202506014

Abstract：Objective To investigate the clinical characteristics of older patients with upper gastrointestinal bleed-ing(上消化道出血).Methods In this retrospective study,90 patients with 上消化道出血 treated at our hospital from January 2023 to January 2025 were enrolled and stratified by age into an older group(≥60 years;40 case)and a non-el-derly group(<60 years;50 case).Baseline characteristics,etiologies,clinical presentations,and outcomes were compared between groups.Results The older group had significantly higher proportions of hypertension,diabetes,cerebrovascu-lar disease,and of having at least one comorbidity(all P<0.05).Regarding etiologic distribution,gastric ulcer was more frequent in the older group(27.50%vs.10.00%,P=0.031),whereas duodenal ulcer was less frequent(17.50%vs.44.00%,P=0.008).Clinically,the older group had lower incidences of hematemesis(35.00%vs.58.00%,P=0.030)and abdominal pain(30.00%vs.52.00%,P=0.036),but a higher incidence of shock(25.00%vs.8.00%,P=0.027).Multivariable logistic regression confirmed older age as an independent risk factor for shock(OR=3.44;95%CI:1.27～9.32;P=0.015).Rates of clinical cure and mortality did not differ significantly between groups;however,the rate of discharge against medical advice due to clinical deterioration was higher in the older group(20.00%vs.6.00%,P=0.044),and length of hospital stay was significantly longer(P<0.001).Conclusion Older patients with 上消化道出血 commonly have multiple comorbidities,with gastric ulcer being a predominant etiology.Their clinical presentation is less typical(less hematemesis and abdominal pain),yet their condition is more severe(higher risk of shock),hospital stays are longer,and overall prognosis is poorer.