Analysis of Risk Factors for Postoperative Morbidity in Perforated Peptic Ulcer

Kim, Jae‐Myung; Jeong, Sang‐Ho; Lee, Young-Joon; Park, Soon-Tae; Choi, Sang-Kyung; Hong, Soon-Chan; Jung, Eun-Jung; Ju, Young‐Tae; Jeong, Chi‐Young; Ha, Woo-Song

doi:10.5230/jgc.2012.12.1.26

Cited by 53 publications

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“…There are studies indicating that morbidity rates increase depending on the presence of concomitant diseases in patients with peptic ulcer perforation (12,(27)(28)(29). Similarly, we identified that our patients who had concomitant diseases had higher morbidity rates.…”

Section: Discussionsupporting

confidence: 57%

“…Parallel with the literature, our patients were identified to have wound site infections and pulmonary complications. We found in our study that age above 60, presence of a concomi- Kim et al (27) stated that age above 60 and female sex constituted the risk factors that influenced post-operative morbidity. In our study, PUP was often seen among men whereas sex was not a significantly influencing factor for morbidity.…”

Section: Discussionsupporting

confidence: 52%

“…According to literature, the presence of concomitant diseases in PUP patients influenced mortality rates (12,(27)(28)(29). We also found that the presence of a concomitant disease had a significant influence on mortality.…”

Section: Discussionmentioning

confidence: 70%

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Risk factors influencing morbidity and mortality in perforated peptic ulcer disease

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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.Key Words: Peptic ulcer perforation, morbidity, mortality, risk factors, time to admission INTRODUCTION Peptic ulcer disease (PUD) is a disease that results from an imbalance between aggressive factors such as stomach acid and pepsin and mucosa defense barriers (1). Although the need for elective surgery has decreased as a result of advances in medical treatment, 10% of the patients require surgery. The choice of treatment for peptic ulcer perforation (PUP) remains to be surgery. Currently, the most preferred surgical method is simple closure and omental plug. Different techniques are also applied (2-4). Factors that influence the prognosis of PUP are listed as follows: time to hospital presentation, large perforation diameter, age over 60 years, presence of shock, presence of concomitant diseases and localization of the perforation in the stomach (5, 6). Preoperative hemodynamic shock, sepsis and generalized peritonitis are important factors influencing morbidity and mortality (5-8). In this study, we examined the risk factors affecting morbidity and mortality in PUD. MATERIAL AND METHODSThe files of 148 patients, who were operated on at Dicle University, School of Medicine, General Surgery Clinic as diagnosed with PUD and received primary closure + omentoplasty were retrospectively examined after the obtainment of approval from Dicle University, School of Medicine, Ethics Committee with the date and number 18.07.2012/663. Written consents indicating that they allowed their data to be used in medical research were obtained from all our patients. The patients who underwent different surgical procedures or had malignant ulcer per...

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Section: Discussionsupporting

confidence: 57%

Section: Discussionsupporting

confidence: 52%

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Risk factors influencing morbidity and mortality in perforated peptic ulcer disease

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et al. 2015

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“…[1][2][3] A large number of prognostic factors for morbidity and mortality in patients with perforated peptic ulcer have been reported. [2][3][4][5][6][7] Several clinical scoring system have been proposed for prognostic prediction. The most wellknown predicted scoring system is Boey score 3, which predicted mortality in PPU patients base on the time from perforation to admission, pre-operative systolic blood pressure and comorbid conditions of patients.…”

Section: Introductionmentioning

confidence: 99%

The accuracy of prognostic scoring systems for post-operative morbidity and mortality in patients with perforated peptic ulcer

Nichakankitti

Athigakunagorn

2016

Int Surg J

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INTRODUCTIONIn urgent surgical procedures for perforated peptic ulcer (PPU), there is considerable postoperative morbidity and mortality. The overall mortality rate is about 9-27%.1-3 A large number of prognostic factors for morbidity and mortality in patients with perforated peptic ulcer have been reported. [2][3][4][5][6][7] Several clinical scoring system have been proposed for prognostic prediction. The most wellknown predicted scoring system is Boey score 3, which predicted mortality in PPU patients base on the time from perforation to admission, pre-operative systolic blood pressure and comorbid conditions of patients. Then Boey score was classified in three groups, score 0, 1 and 2 and mortality rate were 0%, 10% and 100% respectively. Lohsiriwat et al was found that a higher Boey score was associated with increasing rates of both morbidity and mortality and could be considered as a simple and appropriate prognostic marker in the management of PPU. 1The American society of anesthesiologists (ASA) classification is the most commonly used for assessing perioperative risk worldwide. It is graded in six categories; depend on the patient's pre-operative health status. 5 The previous study found that ASA classification ABSTRACT Background: To determine the accuracy of Boey score, American society of anesthesiologists (ASA) score, peptic ulcer perforation (PULP) score and the mannheim peritonitis index (MPI) score and compare each predicted scoring systems for prediction the morbidity and mortality of patients with perforated peptic ulcer. Methods:We retrospectively reviewed the patients with gastric or duodenal ulcer perforation in Bhumibol Adulyadej Hospital, Bangkok, Thailand between 1 January 2008 and 31 December 2012. The morbidity and mortality within 30 days of the PPU patient who underwent the surgical procedure was determined. The predicted scoring systems included Boey score, ASA score, PULP score and MPI score were calculated. We used area under curve of receiver operating characteristics curve to compare the scoring accuracy. Results:The study included 140 patients, Female 17.9% and male 82.1%. The mean age was 48.5 years. The most common site of PPU was the pre-pyloric region (80%). The most common operative procedure was the simple suture with omental graft. The complication rate was 20.71%. Overall mortality rate was 3.57%. The AUC for morbidity prediction was 0.671 for Boey score, 0.684 for ASA score, 0.698 for MPI score and 0.727 for PULP score. The AUC for mortality prediction was 0.728 for Boey score, 0.776 for ASA score, 0.771 for MPI score and 0.784 for PULP score. Conclusions:The PULP score may be the better prognostic scoring system for post-operative morbidity and mortality of PPU patient than Boey score, ASA and MPI.

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“…A relationship between DM and rebleeding in PUB was reported in two articles (3,27). Three articles mentioned that perforated peptic ulcer was associated with DM (3,33,34). Three other related investigations were involved in the present study (6,35,36).…”

Section: Study Selectionmentioning

confidence: 99%

Diabetes increases morbidity and mortality rates in peptic ulcer bleeding: An updated systematic review and meta-analysis

Wei¹,

Lin²

2016

Turk J Gastroenterol

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Analysis of Risk Factors for Postoperative Morbidity in Perforated Peptic Ulcer

Cited by 53 publications

References 17 publications

Risk factors influencing morbidity and mortality in perforated peptic ulcer disease

Risk factors influencing morbidity and mortality in perforated peptic ulcer disease

The accuracy of prognostic scoring systems for post-operative morbidity and mortality in patients with perforated peptic ulcer

Diabetes increases morbidity and mortality rates in peptic ulcer bleeding: An updated systematic review and meta-analysis

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