Beyond chronological age: gastrointestinal bleeding and endoscopy in patients aged 90 years or older

Nonagenarians admitted with NVUGIB are at a higher mortality risk than octogenarians.While EGD is used to a significant extent in managing NVUGIB among nonagenarians, its utilization is comparatively lower when compared to octogenarians.Gastroenterologists should be prepared to encounter a rising number of NVUGIB in this rapidly-growing population.Number of Patients≥80-Years-Old Admitted with NVUGIB • Data source: National Inpatient Sample (NIS) database 2016-2020 • Study design: Retrospective • Sample size: 279,022 hospitalizations OR, 1.5; 95% CI, 1.3-1.7Background/Aims: Nonagenarians will purportedly account for 10% of the United States population by 2050.However, no studies have assessed the outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) in this age group. Methods:The National Inpatient Sample database between 2016 and 2020 was used to compare the clinical outcomes of NVUGIB in nonagenarians and octogenarians and evaluate predictors of mortality and the use of esophagogastroduodenoscopy (EGD).Results: Nonagenarians had higher in-hospital mortality than that of octogenarians (4% vs. 3%, p<0.001).EGD utilization (30% vs. 48%, p<0.001) and blood transfusion (27% vs. 40%, p<0.001) was significantly lower in nonagenarians.Multivariate logistic regression analysis revealed that nonagenarians with NVUGIB had higher odds of mortality (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3-1.7)and lower odds of EGD utilization (OR, 0.86; 95% CI, 0.83-0.89)than those of octogenarians.Conclusions: Nonagenarians admitted with NVUGIB have a higher mortality risk than that of octogenarians.EGD is used significantly in managing NVUGIB among nonagenarians; however, its utilization is comparatively lower than in octogenarians.More studies are needed to assess predictors of poor outcomes and the indications of EGD in this growing population.