Clinical Analysis Of Upper Gastrointestinal Bleeding In Elderly Patients With Coronary Heart Disease (CHD)

Objective:The morbidity and mortality of coronary heart disease (CHD) in China wasincreasing rapidly in recent years which increased with the age．. Elderly CHD patientswill be in critical situation and with high mortality once they encounter uppergastrointestinal bleeding. And it is relatively more difficult for diagnosis, treatment andclinical care. This retrospective analysis of elderly CHD patients combined with uppergastrointestinal bleeding aimed to find its clinical characteristics and guide clinicaldiagnosis and treatment．Methods：From January2010to December2013,128patients with upper gastrointestinalbleeding in Zhongshan Hospital Xiamen University were enrolled in this study. All thepatients were divided into two groups. One group (group A) enrolled64patients withCHD, and the other (group B) with equal patients were matched with no-CHD cases.There is no significant difference between the two groups in general data (P>0.05)．Results: There were no significant differences (P>0.05) between the two groups in thecauses and amount of upper gastrointestinal bleeding, infection rate of H.pylori andmortality.In addition, the ratios of abdominal pain (group A14.1%vs. group B25%),syncope (group A20.3%vs. group B12.5%),blood transfusion (groupA54.7%vs.group B37.5%), surgery treatment (group A33.3%vs. group B85.7%) and death dueto bleeding and its complications (group A80%vs. group B50%) had distinctions, butthey were not significant(P>0.05). There had significant differences (P <0.05) in thecomorbidities (hypertension, diabetes, arrhythmia), complications, accomplished ratios ofgastroscopy, ratios of emergency gastroscopy, rebleeding occurrence and surgery．Conclusions:1. Clinical manifestations are more atypical in elderly CHD patients than non-CHD elderly patients. Patients of elderly CHD are more likely getting worse becauseof complications of mass upper gastrointestinal bleeding.2. The accomplished rate ofgastroscopy is lower in elderly CHD patients than in non-CHD elderly patients because ofsevere situation and worse cardiac and lung function.3. Elderly CHD patients have highrisk of upper gastrointestinal bleeding. Early diagnosis and intervention, increasingpatients’ awareness themselves and preventing rebleeding will be benefit for improvingthe prognosis．...