{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:32:53Z","timestamp":1792513973727,"version":"4.5.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute gastrointestinal bleeding (AGIB) in patients with liver cirrhosis is a frequent and often fatal event. This study aimed to thoroughly characterize the relationship between patients\u2019 age and 6-week mortality. We sought to identify specific risk thresholds and key modifying factors to refine clinical risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 878 patients with liver cirrhosis and AGIB admitted to the Emergency Room at Beijing You\u2019an Hospital. Patients were stratified into age-based tertiles for descriptive analysis. To assess the association between age and 6-week mortality, we built three sequential logistic regression models adjusting for key clinical confounders including the Glasgow-Blatchford Score (GBS), using restricted cubic splines (RCS) to capture non-linear effects and identify risk thresholds. Subgroup analyses and formal tests for interaction were performed to evaluate the consistency of the age-related risk across different clinical scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 6-week mortality rate was highest in the oldest age tertile (18.21%). Age emerged as a significant and independent predictor of mortality in all models. The fully adjusted RCS model identified a critical age threshold of approximately 58\u202fyears, above which mortality risk increased sharply. The prognostic impact of age was particularly pronounced in male patients and those not receiving endoscopic therapy. Notably, a significant interaction was detected between age and intensive care unit (ICU) admission status (\n                      <jats:italic>P<\/jats:italic>\n                      for interaction &amp;lt; 0.05). The strong association between increasing age and higher mortality observed in non-ICU patients was attenuated and no longer significant in those admitted to the ICU. A significant association between increasing age and 6-week mortality was identified in patients with Child-Pugh grade C (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and in medium-risk and high-risk groups (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.011) when patients were stratified based on GBS. Additionally, in the etiological subgroups, age was a significant predictor of 6-week mortality only in patients with viral cirrhosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002) and viral\/alcoholic cirrhosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.01), but not in patients with other etiologies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Age is a critical independent predictor of 6-week mortality in cirrhotic patients with AGIB, but its prognostic effect varies with the level of care. Specifically, It strongly predicts mortality in non-ICU settings, but not in the ICU. This challenges the uniform view of age as a risk factor and suggests that early transfer to higher-level care such as ICU admission may reduce age-related risk in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1709816","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T05:41:10Z","timestamp":1769406070000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Age as a key predictor of 6-week mortality in cirrhotic patients with acute gastrointestinal bleeding: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Qi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You\u2019an Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruifeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Friendship Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenghui","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You\u2019an Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingna","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You\u2019an Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlei","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You\u2019an Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiguo","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You\u2019an Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"l536","DOI":"10.1136\/bmj.l536","article-title":"Management of acute upper gastrointestinal bleeding","volume":"364","author":"Stanley","year":"2019","journal-title":"BMJ"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1053\/j.gastro.2018.02.023","article-title":"New developments in managing variceal bleeding","volume":"154","author":"Ibrahim","year":"2018","journal-title":"Gastroenterology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1053\/jhep.2003.50385","article-title":"Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators","volume":"38","author":"D'Amico","year":"2003","journal-title":"Hepatology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.amjmed.2023.12.001","article-title":"Challenges in the management of esophagogastric varices and variceal hemorrhage in cirrhosis - a narrative review","volume":"137","author":"Gralnek","year":"2024","journal-title":"Am J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1159\/000493854","article-title":"Long-term prognosis of patients with obscure gastrointestinal bleeding: a retrospective cohort study","volume":"100","author":"Arai","year":"2019","journal-title":"Digestion"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/01.mcg.0000155133.50562.c9","article-title":"Acute upper gastrointestinal bleeding in patients with liver cirrhosis and in noncirrhotic patients: epidemiology and predictive factors of mortality in a 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edition)","volume":"7","author":"Zhou","year":"2018","journal-title":"Liver Cancer"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/s0168-8278(01)68827-5","article-title":"Predictors of morbidity and mortality after the first episode of upper gastrointestinal bleeding in liver cirrhosis","volume":"32","author":"del Olmo","year":"2000","journal-title":"J Hepatol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"7372868","DOI":"10.1155\/2020\/7372868","article-title":"The prognosis analysis of liver cirrhosis with acute variceal bleeding and validation of current prognostic models: a large scale retrospective cohort study","volume":"2020","author":"Zhao","year":"2020","journal-title":"Biomed Res Int"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"43","DOI":"10.4103\/1319-3767.151226","article-title":"Predictors of in-hospital mortality among patients presenting with variceal gastrointestinal bleeding","volume":"21","author":"Kumar","year":"2015","journal-title":"Saudi J Gastroenterol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.ajg.2016.11.003","article-title":"Predicting mortality of patients with cirrhosis admitted to medical intensive care unit: an experience of a single tertiary center","volume":"17","author":"Elzouki","year":"2016","journal-title":"Arab J Gastroenterol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e0762","DOI":"10.1097\/hc9.0000000000000762","article-title":"Long-term outcomes after ICU admission in critically ill patients with liver cirrhosis: an Australian state-wide cohort study","volume":"9","author":"Con","year":"2025","journal-title":"Hepatol Commun"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3211","DOI":"10.1007\/s12325-019-01083-5","article-title":"Development and validation of CAGIB score for evaluating the prognosis of cirrhosis with acute gastrointestinal bleeding: a retrospective multicenter study","volume":"36","author":"Bai","year":"2019","journal-title":"Adv Ther"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1038\/s41746-025-01883-w","article-title":"Machine learning based CAGIB score predicts in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding","volume":"8","author":"Bai","year":"2025","journal-title":"NPJ Digit Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1709816\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T05:41:11Z","timestamp":1769406071000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1709816\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,26]]},"references-count":16,"alternative-id":["10.3389\/fmed.2026.1709816"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1709816","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,26]]},"article-number":"1709816"}}