Keywords
Esophagogastroduodenoscopy
Older adults
Upper gastrointestinal bleeding
How to Cite
Abstract
Background: International guidelines recommend endoscopy within 24 hours for upper gastrointestinal bleeding (UGIB), yet real-world timing patterns in older adults remain uncertain.
Methods: We conducted a retrospective single-center cohort study of 108 adults aged ≥75 years admitted with UGIB who underwent inpatient esophagogastroduodenoscopy (EGD) between 2023 and 2025. Early EGD was defined as ≤24 hours from presentation. Baseline characteristics, endoscopic findings, and clinical outcomes were compared between groups.
Results: Among 108 patients, the mean age was 88.1 ± 6.1 years, the median age was 90 years (IQR 83–93), and 35 (32.4%) underwent early EGD, whereas 73 (67.6%) underwent delayed EGD. Baseline characteristics were broadly similar between groups; however, patients undergoing early EGD were more likely to present with shock, suggesting greater illness severity. The median time to EGD was 29.0 hours (IQR 23.0-45.3). Overall, 28-day all-cause mortality occurred in 5 (4.6%) of 108 patients, with no clear difference between early and delayed EGD groups (1 [2.9%] of 35 vs 4 [5.5%] of 73; absolute risk difference, −2.6%; 95% CI, −10.7% to 9.5%; p = 1.00). No statistically significant differences were observed in ICU admission, length of stay, transfusion requirement, readmission, or endoscopic therapy. Estimates were imprecise due to the small number of events.
Conclusions: No clear difference in short-term outcomes was observed between early and delayed EGD in this cohort of older adults. These findings are descriptive and hypothesis-generating and should be interpreted cautiously given the small sample size, low event count, and potential bias.
References
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