Mortality rate and risk factors for gastrointestinal bleeding in elderly patients

patients may be exposed to multiple risk factors for GIB. We aimed at defining the impact of GIB in elderlypatients.Methods: Since 2008, samples of elderly patients (age≥65 years) with multimorbidity admitted to 101 internalmedicine wards across Italy have been prospectively enrolled and followed-up (REPOSI registry). Diagnoses ofGIB, length of stay (LOS), mortality rate, and possible risk factors, including drugs, index of comorbidity(Cumulative Illness Rating Scale [CIRS]), polypharmacy, and chronic diseases were assessed. Adjusted multivariatelogistic regression models were computed.Results: 3872 patients were included (mean age 79 ± 7.5 years, F:M ratio 1.1:1). GIB was reported in 120patients (mean age 79.6 ± 7.3 years, F:M 0.9:1), with a crude prevalence of 3.1%. Upper GIB occurred in 72patients (mean age 79.3 ± 7.6 years, F:M 0.8:1), lower GIB in 51 patients (mean age 79.4 ± 7.1 years, F:M0.9:1), and both upper/lower GIB in 3 patients. Hemorrhagic gastritis/duodenitis and colonic diverticular diseasewere the most common causes. The LOS of patients with GIB was 11.7 ± 8.1 days, with a 3.3% in-hospitaland a 9.4% 3-month mortality rates. Liver cirrhosis (OR 5.64; CI 2.51–12.65), non-ASA antiplatelet agents (OR2.70; CI 1.23–5.90), and CIRS index of comorbidity>3 (OR 2.41; CI 1.16–4.98) were associated with GIB(p < 0.05).Conclusions: A high index of comorbidity is associated with high odds of GIB in elderly patients. The use of non-ASA antiplatelet agents should be discussed in patients with multimorbidity.