RT Journal Article
SR Electronic
T1 <span class="underline">S</span>elective <span class="underline">O</span>utpatient <span class="underline">M</span>anagement of Upper Gastrointestinal Bleeding in the <span class="underline">E</span>lderly: Results from the <em>SOME</em> Bleeding Study
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 195
OP 201
VO 1
IS 4
A1 Francisco Cebollero-Santamaria
A1 James Smith
A1 Scott Gioe
A1 Timothy Van Frank
A1 Ricardo McCall
A1 Joanne Airhart
A1 Robert Perrillo
YR 1999
UL http://www.ochsnerjournal.org/content/1/4/195.abstract
AB To determine whether elderly patients with upper gastrointestinal bleeding could be safely managed as outpatients, 84 patients (65 years and older) were studied over a 23-month period. Urgent outpatient endoscopy was performed and clinical as well as endoscopic criteria were applied to determine the need for hospital admission. Patients with endoscopic findings that indicated a low risk for rebleeding were not admitted if they lacked one major or three minor predefined clinical criteria. All enrollees were monitored with hematocrit determination and clinical assessments for 4 weeks after discharge from the clinic or hospital. Twenty-four (29%) patients were treated as outpatients; none rebled. In contrast, seven (12%) of the 60 inpatients had one or more rebleeding episodes (p = 0.002). Bleeding from peptic ulcer disease was associated with use of nonsteroidal anti-inflammatory medications in 81% of patients. We conclude that selective outpatient management of elderly patients with upper gastrointestinal bleeding can be done safely and can potentially reduce health care expenditures.