Abstract

Background: Acute gastrointestinal bleeding (GIB) represents a major challenge in elderly patients, and computed tomography angiography (CTA) can facilitate diagnostic tests for the detection of the source of GIB. We aimed to evaluate the outcomes of elderly patients with GIB who had positive CTA findings.

Methods: A 6-year retrospective review was conducted on elderly patients (aged ≥ 65 years) who underwent CTA for GIB. The patients were assigned to the positive and negative CTA groups. The clinical characteristics, treatment strategies, and outcomeswere comparatively analyzed between the groups.

Results: Among 306 patients, 88 (28.8%) showed positive CTA findings. Blood transfusion (packed red blood cells [PRBC] > 4 U) and coagulopathy were statistically significantly different between the two groups. Treatment approaches varied based on the bleeding origin, with endoscopy, transarterial embolization (TAE), and conservative management being the primary modalities. Five (5.7%) patients in the CTA-positive group died despite receiving treatment, mostly due to late complications rather than due to uncontrolled bleeding.

Conclusion: Elderly patientswith GIB who exhibited coagulopathy and required blood transfusion (PRBC > 4 U) are at an increased risk for positive CTA. The management strategies varied based on the bleeding origin. Despite the successful control of bleeding in most cases, mortality was primarily due to late complications, such as infections and organ failure, rather than due to persistent hemorrhage.