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The impact of early gastroscopy examination on cardiovascular event-related indices in elderly patients with acute upper gastrointestinal bleeding

Medicine (Baltimore). 2024 Mar 29;103(13):e37378. doi: 10.1097/MD.0000000000037378.

ABSTRACT

BACKGROUND: To observe the effects of early gastroscopy examination on cardiovascular event-related indicators such as heart rate (HR), blood pressure, and electrocardiogram (ECG) in elderly patients with acute upper gastrointestinal bleeding.

METHODS: Sixty patients with upper gastrointestinal bleeding admitted from July 2022 to December 2022 were selected. Patients with relevant contraindications were excluded. All patients underwent early gastroscopy examination. Among them, 30 patients were aged 60 or above (elderly group) and 30 patients were aged below 60 (non-elderly group). Dynamic blood pressure and ECG recordings were obtained before, during, and after gastroscopy examination to assess changes in HR, blood pressure, and ECG.

RESULTS: The HR and blood pressure levels of the elderly group were significantly lower than those of the non-elderly group before, during, and after gastroscopy examination (P < .05). In the elderly group, blood pressure and HR were higher during gastroscopy examination compared to before, but lower than during the examination afterward, with statistically significant differences (P < .05). The diastolic blood pressure was lower after the examination compared to before, with statistical significance, while the systolic blood pressure was lower, and the HR was higher after the examination, but without statistical significance (P > .05). In the non-elderly group, systolic blood pressure and HR were higher during gastroscopy examination compared to before, with statistically significant differences (P < .05), while diastolic blood pressure was higher but without statistical significance (P > .05). Blood pressure and HR were lower after the examination compared to during, with statistically significant differences (P < .05). The occurrence rates of ECG changes were 70% in the elderly group and 30% in the non-elderly group, with a statistically significant difference (χ2 = 5.45, P = .02 < .05).

CONCLUSION: Early gastroscopy examination in elderly patients with gastrointestinal bleeding did not result in severe cardiovascular adverse events and was relatively safe. However, special attention should be given to the occurrence of cardiac arrhythmias.

PMID:38552068 | DOI:10.1097/MD.0000000000037378

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