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Short and long term course of elderly patients with peptic ulcer bleeding--analysis of factors influencing fatal outcome.

OBJECTIVE
To study long and short term survival in patients aged 60 years or over admitted with a peptic ulcer bleeding and find out which factors influence outcome.


DESIGN
Cohort study with matched controls.


SETTING
Two emergency hospitals, Sweden


PATIENTS
676 of the 687 patients aged 60 years or over admitted to the two emergency hospitals serving Gothenburg, Sweden during 1989-1993 who fulfilled the diagnostic criteria and whose case notes were available for study.


MAIN OUTCOME MEASURES
Seven year survival rates and odds ratios for risk factors based on multiple logistic regression analyses.


RESULTS
37 patients died and the timing was evenly distributed within the first 30 days of admission with a cumulated case-fatality rate of 5.5% at day 30. Mortality was increased among the patients compared with the control group during the subsequent years. Factors that influenced day 30 mortality were age and Forrest class.


CONCLUSION
Mortality is increased among patients with peptic ulcer bleeding even long after the event. Old age and signs of recent haemorrhage increase the risk.