SUMMARY The factors that determine the recurrence rate of chronic gastric ulcer were studied in 105 patients. It was found that complete healing of the ulcer significantly reduced the recurrence rate and subsequent need for hospital admission because of ulcer symptoms when this group was compared with those who left hospital with their ulcers unhealed. Those admitted with large ulcers also had a higher recurrence rate. The age and sex of the patient, ingestion of analgesics and cigarette smoking did not influence recurrence. The initial healing rate of the ulcer also had no effect on the subsequent course of the patient.
SUMMARY 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 (t< 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.Hospital admission has been shown to have a beneficial effect on the rate of healing of chronic gastric ulcers (Doll and Pygott, 1952;Herrmann and Piper, 1973), but the value ofshort-termhealingon the long-term prognosis has been little investigated. We have recently demonstrated that up to two years after an admission to hospital for chronic gastric ulcer, patients whose ulcer had been healed at the time of discharge did better, having fewer recurrences and admissions to hospital than those whose ulcer was unhealed when they left hospital . The present study reports the comparative outcome for these groups during the four 'Address for reprints: Professor
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