Gastric emergencies in older adults: not always the same old story! A tertiary care emergency department observational cohort study. Issue 1 (25th January 2022)

• Record Type: Journal Article
• Authors: Rosa, Fausto; Covino, Marcello; Fransvea, Pietro; Cozza, Valerio; Quero, Giuseppe; Fiorillo, Claudio; Simeoni, Benedetta; La Greca, Antonio; Sganga, Gabriele; Gasbarrini, Antonio; Franceschi, Francesco; Costamagna, Guido; Alfieri, Sergio
• Is Part Of: BMJ open. Volume 12:Issue 1(2022)
• Publication Date: 2022-01-25
• Subjects: surgery -- adult gastroenterology -- endoscopy -- adult surgery; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-056981
• Languages: English
• ISSNs: 2044-6055

Abstract

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.