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Background <p>Studies show declining non-variceal upper gastrointestinal bleeding (NVUGIB) incidence and hospitalization, likely due to novel pharmacological and endoscopic therapies. However, data on mortality and outcomes in octogenarians with NVUGIB remain limited.</p> Methods <p>We conducted a retrospective cohort study using the TriNetX platform, identifying adults NVUGIB between January 1, 2014, and May 18, 2025. Patients with gastroesophageal variceal bleeding were excluded. Two age cohorts (&gt; 80&#xa0;years and 18–65&#xa0;years) were 1:1 propensity matched according to sex, demographics, comorbidities, and medications. The primary outcome was risk of all-cause mortality. Secondary outcomes included in-hospital and procedure-related outcomes. Cox-proportional hazards models estimated hazard ratios (HR) with 95% confidence intervals (CIs).</p> Results <p>117,695 octogenarians (mean [SD] age, 81.4 [5.3] year; 59,524 [50.6%] female) were matched with 117,695 patients &lt; 65&#xa0;years (mean [SD] age, 44.9 [13.6] year; 60,044 [51.0%] female). The octogenarian cohort had significantly higher all-cause mortality (HR, 2.73; 95% CI 2.60–2.87), acute kidney injury (HR, 1.61; 95% CI 1.56–1.66), mechanical ventilation (HR, 1.17; 95% CI 1.12–1.23), hypovolemic shock (HR, 1.54; 95% CI 1.40–1.70), and intensive care unit admission (HR, 1.10; 95% CI 1.06–1.13) compared to those aged under 65&#xa0;years. Subgroup analysis comparing the timing of endoscopy and its effect on mortality showed increased all-cause mortality in octogenarians with NVUGIB and early endoscopy (HR, 2.04; 95% CI 1.81–2.30).</p> Conclusion <p>Through this multicenter retrospective study, we demonstrate that octogenarians with NVUGIB have a 2.7-fold higher risk of all-cause mortality. This study emphasizes the importance of early diagnosis, aggressive management, and risk stratification to improve outcomes in this population.</p>

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Risk of 30-day all-cause mortality in octogenarians with non-variceal upper gastrointestinal bleeding: a multinational analysis

  • 期刊论文

  • 发表日期：

    2026年4月15日

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  • Do Han Kim,
  • Jose A. Porres,
  • Donghyun Ko,
  • Denisa Costea,
  • Sharon I. Narvaez,
  • Luis M. Nieto,
  • Frank J. Lukens,
  • Pedro Palacios Argueta,
  • Ben M. W. Illigens,
  • Tiago L. Cerqueira,
  • Paul T. Kröner

摘要

Background

Studies show declining non-variceal upper gastrointestinal bleeding (NVUGIB) incidence and hospitalization, likely due to novel pharmacological and endoscopic therapies. However, data on mortality and outcomes in octogenarians with NVUGIB remain limited.

Methods

We conducted a retrospective cohort study using the TriNetX platform, identifying adults NVUGIB between January 1, 2014, and May 18, 2025. Patients with gastroesophageal variceal bleeding were excluded. Two age cohorts (> 80 years and 18–65 years) were 1:1 propensity matched according to sex, demographics, comorbidities, and medications. The primary outcome was risk of all-cause mortality. Secondary outcomes included in-hospital and procedure-related outcomes. Cox-proportional hazards models estimated hazard ratios (HR) with 95% confidence intervals (CIs).

Results

117,695 octogenarians (mean [SD] age, 81.4 [5.3] year; 59,524 [50.6%] female) were matched with 117,695 patients < 65 years (mean [SD] age, 44.9 [13.6] year; 60,044 [51.0%] female). The octogenarian cohort had significantly higher all-cause mortality (HR, 2.73; 95% CI 2.60–2.87), acute kidney injury (HR, 1.61; 95% CI 1.56–1.66), mechanical ventilation (HR, 1.17; 95% CI 1.12–1.23), hypovolemic shock (HR, 1.54; 95% CI 1.40–1.70), and intensive care unit admission (HR, 1.10; 95% CI 1.06–1.13) compared to those aged under 65 years. Subgroup analysis comparing the timing of endoscopy and its effect on mortality showed increased all-cause mortality in octogenarians with NVUGIB and early endoscopy (HR, 2.04; 95% CI 1.81–2.30).

Conclusion

Through this multicenter retrospective study, we demonstrate that octogenarians with NVUGIB have a 2.7-fold higher risk of all-cause mortality. This study emphasizes the importance of early diagnosis, aggressive management, and risk stratification to improve outcomes in this population.