Risk Factors Affecting Morbidity and Mortality of Peptic Ulcer Perforations at Surin Hospital
Article Sidebar
Main Article Content
Abstract
Background: Perforation is the second most common complication of peptic ulcer disease and remains a serious condition which generally requires emergency surgical intervention.
Objective: To study the morbidity and mortality rate and evaluate factors affecting postoperative complications of perforated peptic ulcer.
Method: A retrospective reviewed of 140 patients operated on for perforated peptic ulcer between January 2009 and December 2009 at Surin hospital. A total 131 patients with perforated peptic ulcer were included, 9 patients were excluded from the study.
Result: 131 patients with a mean age of 61.31 years (range, 19-86) were included,
108 (82.4%) were males and 23 (17.6%) were females. In 131 patients, 26 complications were recorded in 15 patients (11.5%), there were 7 deaths (5.3%). A significantly factors affecting postoperative complications was age, duration of symptom prior to admission, delay of treatment and operative time. An increase in the APACHE II score (p-value < 0.001), reduced white blood cell count (p-value < 0.001) and hematocrit (p-value < 0.001) were highly significant for the prediction of postoperative complications and postoperative deaths.
Conclusion: The morbidity and mortality rate of perforated peptic ulcer were 11.5% and 5.3% respectively. In the patients with old age, high APACHE II score, prolong duration of symptom prior to admission and delay of treatment are risk factor associated with fatal and postoperative complicated outcomes in patients undergoing emergency surgery for perforated peptic ulcer.
Key word: Peptic ulcer perforation, morbidity, mortality.
Article Details
References
Dempsey DT. Stomach. In : Brunicardi FC, Andersen DK. Billiar TR Dunn DL, Hunter JG. Matthews JB, et al. Schwartz’s principle of Surgery. 9th ed. New York : Me Graw Hill ; 2009 : 889-948.
Lena Napolitano. Refractory Peptic Ulcer Disease. Gastroenterol Clin N Am 2009 ; 38 :267-88.
Ramakrishnan K. Peptic Ulcer Disease. Am Fam Physician 2007; 76 (7):1005-12.
Saad RJ. Scheiman JM. Diagnosis and Management of Peptic Ulcer Disease. Gastroenterology 2004; 6 (3):569-87.
Adrienne Z. Abies, I. Simon, Emily R. Melton. Update on Helicobacter pylori Treatment. Am Fam Physician 2007; 75 (3); 351-58.
Leong RW. Differences in Peptic Ulcer Between the East and the West Gastroenterol Clin N Am 2009; 38:363-79.
Svanes C. Trends in perforated peptic ulcer: incidence, etiology, treatment and prognosis. World J Surg 2000;24:277-83.
Sarosi GA, Jaiswal KR, Nwariaku FE, Asolati M, Fleming JB, Anthony T. Surgical therapy of peptic ulcer in the 21st century: more common than you think. Am J Surg 2005; 190:775-9.
Tokunaga Y, Hata K, Ryo J, Kitaoka A, Tokuka A, Ohsumi K.J Am. Density of Helicobacter pylori Infection in Patients with Peptic Ulcer Perforation. J Am Coll Surg 1998;186(6):659-63.
Gisbert JP, Legido J, Garcia-Sanz I, Pajares JM. Helicobacter pylori and perforated peptic ulcer Prevalence of the infection and role of non-steroidal anti-inflammatory drugs. Dig Liver Dis 2004; 36:116-20.
Bertleff MJ, Halm JA Bemelman WA van der Ham AC, van der Harst E, Oei HI, et al. Randomized Clinical Trial of Laparoscopic Versus Open Repair of the Perforated Peptic Ulcer: The LAMA Trial. World J Surg 2009; 33:1368-73
Torab FC, Amer M Abu-Zidan FM, Branicki FJ. et al. Perforated Peptic Ulcer: Different Ethnic, Climatic and Fasting Risk Factors for Morbidity in Al-Ain Medical District, United Arab Emirates. Asian J Surg 2009; 32 (2):95-101.
Svanes C, Lie RT, Lie SA Kvale G, Svanes K, Soreide O. Survival After Peptic Ulcer Perforation: A Time Trend Analysis. J Clin Epidemiol 1996; 49 (12):1363-71.
Thors H, Svanes C, Thjodleifsson B. Trends in peptic ulcer morbidity and mortality in Iceland. J Clin Epidemiol 2002; 55:681-86.
Arid C, Mesci A, Dincer D, et al. Analysis of risk factors predicting (affecting) mortality and morbidity of peptic deer perforations. Int Surg 2007; 92:147-54.
Chou NH, Mok KT, Chang HT, et al. Risk factors of mortality in perforated peptic ulcer. Eur J Surg 2000; 166:149-53.
Kocer B, Surmeli S, Solak C, et al. Factor affecting mortality and morbidity in patients with peptic deer perforation. J Gastroenterol Hepatol 2007; 22:565-70.
Higham J, Kang JY, Majeed A. Recent trend in admission and mortality due to peptic ulcer in England: increasing frequency of hemorrhage among older subjects. Gut 2002; 50:460-4.
Li CH, Bair MJ, Chang WH, Shih SC, Lin SC, Yeh CY. Predictive model for length of hospital stay of patients surviving surgery for perforated peptic deer. J Formos Med Assoc 2009; 108 (8):644-52.
