E0301 - Characteristics and Outcomes of Geriatrics Patients Admitted for Upper Gastrointestinal Bleeding: A Population-Based Age-Stratified Retrospective Study

Introduction: Advanced age is a well-known risk factor for mortality in Upper Gastrointestinal Bleeding (UGIB). However, the characteristics and outcomes of elderly patients hospitalized for UGIB remains understudied.

Methods: Using ICD-10 codes, the National Inpatient Sample database of the years 2016 to 2019 was searched for to geriatric (≥ 65 years old) and non-geriatric (18-65 years old) patients who were admitted with a primary diagnosis of UGIB. Multivariate logistic regression analysis was performed to determine the risk of mortality and in-hospital complications in geriatric patient admitted for UGIB compared to their younger counterparts. Baseline patients and facilities characteristics were incorporated into the analysis. Data was considered statistically significant if p-value was < 0.05.

Results: Among 1,656,594 adults’ patients who were hospitalized in US with a primary diagnosis of UGIB from 2016 - 2019, 1,022,295 (61.7%) were ≥ 65 years old. Age-stratified patients baseline characteristics are listed in Table 1. Geriatric patients have a 1.7-fold increase in risk of UGIB (OR 1.74, p< 0.001) with 1.9-fold increase in risk of mortality (OR 1.91, p< 0.001). In term of in-hospital outcomes (Figure 1), Geriatric patients had a higher risk of septic shock (OR 1.26, p< 0.001), acute kidney injury (OR 1.59, p< 0.001), acute coronary syndrome (OR 1.37, p< 0.001), in-hospital cardiac arrest (OR 1.65, p< 0.001), hypovolemic shock (OR 1.11, p< 0.001), UTIs (OR 1.89, p< 0.001), pneumonia (OR 1.36, p< 0.001), malnutrition (OR 1.41, p< 0.001) and acute respiratory failure (OR 1.22, p< 0.001) when comparted to non-geriatric patients. Interestingly, geriatric/UGIB patients had no significant difference in length of stay (Coefficient 0.28 days, p< 0.001) and cost of care (Coefficient -750$, p< 0.001) when compared to younger subjects.

Discussion: Geriatric population suffering UGIB have higher rates of mortality, septic shock, acute kidney injury, acute coronary syndrome, in-hospital cardiac arrest, hypovolemic shock, UTIs, pneumonia and acute respiratory failure with similar healthcare resources utilization to younger subjects. These results are likely related to the higher comorbidities and the benefits/risk balance of undergoing invasive therapeutic measures in this friable age group. This necessitates proper risk stratification, treatment protocols and early identification of goals of care for geriatric patients admitted for UGIB.