The management of bleeding peptic ulcer in the elderly with heater probe thermocoagulation

BACKGROUND/AIMS: The aim of this study was to compare the clinical characte ristics of bleeding peptic ulcers in the elderly with those in younger pati ents, retrospectively. METHODOLOGY: Between 1986 and 1994, 274 patients with bleeding peptic ulcer s were treated with heater probe endoscopically. They were divided into 2 g roups: 48 in the elder group (70 years of age or older) and 226 in the youn ger group (<70). We evaluated the rate of concomitant disease, rebleeding r ate, incidence of emergency surgery, mortality and blood transfusion requir ement between the 2 groups. RESULTS: The incidence of concomitant disease was significantly higher in t he elderly group (83.3%) than in the younger group (33.3%) (p<0.01). The ra te of rebleeding (younger group 23.5% vs. elderly group 31.3%), the inciden ce of emergency surgery (5.8% vs. 6.3%, respectively) and the rate of morta lity due to hemorrhage (2.2% vs. 4.2%, respectively) were similar in the 2 groups. There was no significant difference in the mean volume of blood tra nsfused. CONCLUSIONS: It was revealed that aggressive endoscopic hemostasis improved the mortality rate and the incidence of emergency surgery in elderly patie nts as well as in younger patients, provided that their general condition w as monitored carefully.