Gastric emergencies in older adults: not always the same old story! A tertiary care emergency department observational cohort study

Objective: To analyze and compare the clinical outcomes between patients ≥80 years and patients 65-79 years, presented to our Emergency Department (ED) with the two most common Gastric Emergencies (GE) clinical presentation, i.e. gastric bleeding and gastric perforation.

Design: Single-center retrospective cohort study.

Participants: A total of 1011 patients were enrolled: 421 patients aged ≥80 years were compared to a group of 590 patients aged 65-79 years.

Primary and secondary outcome measures: The primary outcome was to compare the overall mortality. Secondary outcomes included major complications, in-hospital length of stay (LOS), and need for surgical procedures.

Results: Patients ≥80 years with GE had different presentation at Emergency Department compared to younger patients: they had higher gastrointestinal bleeding (24.9% vs. 16.3%; p = 0.001), anemization (14.5% vs. 8.8%; p= 0.005), and shock (10.9% vs. 5.1%; p = 0.001) rates. Median LOS, cumulative major complications and mortality rates were similar among the two groups.

Multivariate analysis identified shock, gastric malignancy, and gastric fistula as independent predictors for survival.

Conclusions: Patients ≥80 years with GE did not have a higher mortality rate and cumulative major complications as compared to younger elderly patients. Invasive treatments were not associated to a different prognosis in this age group.

Methods
Design: Single-center retrospective cohort study.

Participants: A total of 1011 patients were enrolled: 421 patients aged ≥80 years were compared to a group of 590 patients aged 65-79 years.

Primary and secondary outcome measures: The primary outcome was to compare the overall mortality. Secondary outcomes included major complications, in-hospital length of stay (LOS), and need for surgical procedures.