Risk factors influencing morbidity and mortality in perforated peptic ulcer disease
İlhan Taş1, Burak Veli Ülger2, Akın Önder2, Murat Kapan2, Zübeyir Bozdağ2
1Clinic of General Surgery, Ministry of Health Cizre State Hospital, Şırnak, Turkey
2Department of General Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey
Objective: Peptic ulcer perforation continues to be a major surgical problem. In this study, risk factors that influence morbidity and mortality in perforated peptic ulcer disease were examined.
Material and Methods: Files of 148 patients who were included in the study due to peptic ulcer perforation between January 2006 and December 2010 were retrospectively analyzed. Data regarding age, gender, complaints, time elapsed between onset of symptoms and hospital admission, physical examination findings, co-morbid diseases, laboratory and imaging findings, length of hospital stay, morbidity and mortality were recorded.
Results: The study group included 129 (87.2%) male and 19 (12.8%) female patients. The mean age was 51.7±20 (15-88) years. Forty five patients (30.4%) had at least one co-morbid disease. In the postoperative period, 30 patients (20.3%) had complications. The most common complication was wound infection. Mortality was observed in 27 patients (18.2%). The most common cause of mortality was sepsis. Multivariate analysis revealed age over 60 years, presence of co-morbidities and Mannheim peritonitis index as independent risk factors for morbidity. Age over 60 years, time to admission and Mannheim peritonitis index were detected as independent risk factors for mortality.
Conclusion: Early diagnosis and proper treatment are important in patients presenting with peptic ulcer perforation.
Keywords: Peptic ulcer perforation, morbidity, mortality, risk factors, time to admission
Ethics committee approval was received for this study from the ethics committee of Dicle University Faculty of Medicine (18.07.2012/663).
Written informed consent was obtained from patients who participated in this study.
Concept - İ.T.; Design - A.Ö.; Supervision - A.Ö.; Funding - İ.T.; Materials - B.V.Ü.; Data Collection and/or Processing - İ.T.; Analysis and/or Interpretation - M.K., Z.B.; Writer - M.K., A.T.; Critical Review - B.V.Ü., A.Ö.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.