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Acute upper gastrointestinal bleeding in the aged. A retrospective analysis of 100 cases.

One hundred consecutive patients (predominantly men, aged 60 years and older), who were admitted to the Hsinhua Hospital, Shanghai, with acute bleeding from the gastrointestinal tract during a three-year period, were reviewed. The most common causes of bleeding were peptic ulcers, chronic gastritis, prolapse of gastric mucosa, and other benign conditions. In 22 patients, bleeding was either due to oesophageal varices, or was a complication of cor pulmonale. The incidence of malignant disease was 23% (higher than that reported from the United States or the United Kingdom). The mortality rate in patients with benign causes of gastrointestinal bleeding (after exclusion of patients with malignant disease, cor pulmonale, and hepatic cirrhosis) was 4.4%--much lower than the British rate, but slightly higher than that reported in an Australian study. It is hoped that, with the increasing interest in geriatrics, and closer attention to acute bleeding from the gastrointestinal tract in the aged, the mortality rate from this condition will decline.