Gastric ulcer in old age.

One hundred and eleven (16%) of 701 patients with gastric ulcers, admitted to Kommunehospitalet, Copenhagen, from 1955 to 1964, were 70 years of age of older. Of those elderly patients, 43 were treated surgically, 68 non-surgically. The incidences of hemorrhage and extragastric diseases were significantly greater in older patients, whereas the incidence of pain, site of pain, ulcer size, and location, incidence of combined ulcers and gastric retention did not differ from those observed in younger patients. The duration of symptoms was shorter in the aged, though the difference was not significant. Prognosis was less favourable in the aged, largely due to a higher incidence of hemorrhage (47%) and of accessory diseases (47%). The mortality in elderly patients suffering from hemorrhage and accessory diseases was 64% during hospitalization, but only 4% in patients without accessory diseases. Follow-up and autopsy studies of discharged patients revealed that ulcers healed in only half of the non-surgical patients and that surgery was ultimately necessary in 50% of these. It was concluded that the factors which prescribed surgical treatment in elderly patients with gastric ulcers did not differ considerably from those in younger patients. The risk was greater, but this was also true in non-surgical treatment. Close cooperation between surgeon and physician was essential, both pre- and postoperatively, since accessory diseases were very significant for the outcome.