Perforated peptic ulcer: Risk factors for morbidity and mortality

PERFORATED PEPTIC ULCER: RISK FACTORS FOR MORBIDITY AND MORTALITYAim: Perforated peptic ulcer remains a crucial surgical problem. In this study, we examined the risk factors for morbidity and mortality in perforated peptic ulcer.Materials: The retrospective study included 148 patients who were operated on due to perforated peptic ulcer between January 2006 and December 2010. Age, gender, symptoms at admission, time between first symptoms to hospital admission, physical signs, accompanying diseases, laboratory and imaging parameters, surgical procedures, duration of hospital stay, and morbidity and mortality were recorded.Results: The patients comprised 129 (87.2%) males and 19 (12.8%) females, with a mean age of 51.7±20 (15-88) years. Forty-five (30.4%) patients had at least one accompanying disease. Total complication occurred in 30 (20.3%) patients. Wound infection was the most common complication. Total mortality occurred in 27 (18.2%) patients. Sepsis was the most common cause for mortality. In univariate analysis, morbidity was statistically associated with 60 years above, accompanying diseases, perforation diameter, and Mannheim peritonitis index while mortality was associated with the mean age of the patient group, time between first symptoms to hospital admission, presence of preoperative shock, presence of accompanying diseases, perforation diameter, Mannheim peritonitis index, and acute physiology and chronic health evaluation II. In multivariate logistic regression analysis, independent risk factors for morbidity included over 60 years of age, accompanying diseases, and Mannheim peritonitis index while the ones for mortality comprised over 60 years of age, time between first symptoms to hospital admission, and Mannheim peritonitis index.Conclusion: Early diagnosis and proper treatment play a vital role for the cases with perforated peptic ulcer.Keywords: Perforated peptic ulcer, morbidity, mortality, risk factors, admission time.