{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:33:52Z","timestamp":1776990832532,"version":"3.51.4"},"reference-count":54,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"FCT\/MCTES","award":["UIDB\/04585\/2020"],"award-info":[{"award-number":["UIDB\/04585\/2020"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Upper gastrointestinal bleeding (UGIB) is a major medical emergency. Although older citizens have an increased risk of UGIB, guidelines do not fully address specific concerns in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We aimed to report characteristics\/differences between the older (\u2a7e65\u2009years) and the younger adult patients (&lt;65\u2009years) with UGIB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective multicenter cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Adult patients consecutively admitted due to evidence of UGIB at six participating centers or who developed UGIB while hospitalized for another reason during a 6-month enrollment period, were eligible for this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 600 patients included, 58.2% were men. Patients aged \u2a7e65\u2009years comprised 72.8% of the cohort; in this group, most comorbidities (except liver cirrhosis) and use of antiplatelet\/anticoagulant therapy were more frequent (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Variceal UGIB was more common in the younger group and non-variceal UGIB in the older (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The risk scores Glasgow\u2013Blatchford (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003) and Complete Rockall (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were higher in the older group. Peptic ulcer disease was the most common cause in both groups, and angiodysplasia was an almost exclusive diagnosis in the elderly. Overall mortality was 15% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200990), with 76 deaths attributed to non-bleeding causes. In a post hoc subgroup analysis excluding cirrhotic patients, older adults required hospitalization (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.007) and longer hospital stays (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.005) more frequently, while younger patients had higher intensive care unit admission rates (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.018). Multivariate analysis in this subgroup suggested that antiplatelet (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.047) or anticoagulant use (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.021), Rockall score (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and Charlson Comorbidity Index (CCI,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.011) were independently associated with in-hospital mortality. The CCI, higher in older patients, also correlated with the need for blood transfusions (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001), rebleeding (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.013), second-look endoscopy (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and re-hospitalization (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Older adults with UGIB exhibit clinical features associated with higher healthcare resource utilization and worse outcomes. Cirrhosis was linked to adverse outcomes in younger patients. In non-cirrhotic patients, UGIB may share features of geriatric syndromes, reflecting multifactorial risks in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848251343416","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T09:00:48Z","timestamp":1749459648000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Upper gastrointestinal bleeding differences between older and younger adults: should bleeding in non-cirrhotic patients be considered a geriatric syndrome?"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3757-6172","authenticated-orcid":false,"given":"Francisco","family":"Vara-Luiz","sequence":"first","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Avenida Torrado da Silva, Almada 2805-267, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal"}]},{"given":"Ivo","family":"Mendes","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal"}]},{"given":"Carolina","family":"Palma","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal"}]},{"given":"Paulo","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal"}]},{"given":"Diogo","family":"Simas","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Unidade Local de Sa\u00fade da Regi\u00e3o de Leiria, Leiria, Portugal"}]},{"given":"Pl\u00e1cido","family":"Gomes","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Unidade Local de Sa\u00fade da Regi\u00e3o de Leiria, Leiria, Portugal"}]},{"given":"Andr\u00e9","family":"Ruge Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Unidade Local de Sa\u00fade da Regi\u00e3o de Leiria, Leiria, Portugal"}]},{"given":"In\u00eas","family":"Sim\u00e3o","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Unidade Local de Sa\u00fade de Lisboa Ocidental, Lisboa, Portugal"}]},{"given":"Madalena","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Unidade Local de Sa\u00fade da Arr\u00e1bida, Set\u00fabal, Portugal"}]},{"given":"Sara","family":"Ramos Lopes","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Unidade Local de Sa\u00fade da Arr\u00e1bida, Set\u00fabal, Portugal"}]},{"given":"Francisca","family":"C\u00f4rte-Real","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital do Divino Esp\u00edrito Santo de Ponta Delgada, Ponta Delgada, Portugal"}]},{"given":"Maria","family":"Ant\u00f3nia Duarte","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital do Divino Esp\u00edrito Santo de Ponta Delgada, Ponta Delgada, Portugal"}]},{"given":"Catarina","family":"Bravo","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Unidade Local de Sa\u00fade de Loures-Odivelas, Lisboa, Portugal"}]},{"given":"Marta","family":"Patita","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"}]},{"given":"Gon\u00e7alo","family":"Nunes","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal"}]},{"given":"Pedro","family":"Pinto-Marques","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"}]},{"given":"Jorge","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Almada, Portugal"}]}],"member":"179","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X14538688"},{"key":"e_1_3_4_3_2","volume-title":"Sleisenger and Fordtran\u2019s gastrointestinal and liver disease","author":"Feldman M","year":"2020","unstructured":"Feldman M, Friedman LS, Brandt LJ (eds). 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