Gastrointestinal bleeding in the elderly. Morbidity, mortality and cause.

One hundred thirty-six consecutive patients with upper gastrointestinal bleeding were divided by age into three groups, young, middle aged and elderly, and evaluated for the causes and complications of the bleeding episode. Hemorrhagic gastritis was the most frequent source of bleeding in the young, while gastric ulcer was more common in the middle aged and elderly groups. The high mortality in the young (20 percent) was often attributable to associated liver functional abnormalities secondary to alcoholism. The elderly fared better than the young when the source of bleeding was hemorrhagic gastritis, although the results were not statistically significant. On the other hand, the elderly had a significantly higher mortality than the young when the source was gastric ulcer. All three groups did poorly when the source of bleeding was esophageal varices. The mortality rate was essentially the same in the young and elderly patients requiring surgery, suggesting that age alone should not be a deterrent for surgical management of acute gastrointestinal bleeding.