Eighty three patients were followed-up for four years after an admission to hospital with a chronic gastric ulcer proven by radiology (index ulcer). The index ulcer healed completely in 50 patients, but was unhealed at the time of discharge in the other 33. Significantly fewer patients whose index ulcer was healed compared with those whose ulcer was unhealed at discharge had had a recurrence by one (p < 0·05), two, three and four years' (p < 0·01) follow-up. Moreover, the rate of recurrence was significantly greater for those patients with unhealed, compared with those with a healed index ulcer (p < 0·05) and by the end of the four-year period 61% of patients with unhealed, compared with 26% of those with healed index ulcers had had a recurrence. Patients over the age of 60 years with unhealed index ulcers had a significantly poorer prognosis than those of similar age whose index ulcer was healed at discharge (p < 0·025). The sex of the ulcer patient did not significantly influence ulcer recurrence. Large ulcers (> 57 mm2) were less often healed on initial discharge and were more frequently associated with recurrence at one (p < 0·05), two (p < 0·025), three and four years (p < 0·01) than smaller ulcers ([unk]57 mm2). Heavy intake of analgesics adversely influenced the course of patients whose ulcer was unhealed (p < 0·05), but did not alter the recurrence rate in those whose ulcer was healed. Ulcer recurrence was not influenced by smoking habits or by alcohol consumption.
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