Risk Factors Predicting Morbidity and Mortality in Peptic Ulcer Perforation at Maharaj Nakorn Chiangmai Hospital
Abstract
Background: Peptic ulcer perforation (PUP) is one of the important problems in Maharaj Nakorn Chiangmai Hospital due to high morbidity and mortality. If the risk factors of these outcomes are identified, modification of these risk factors may improve the outcomes. This study was conducted to identify these risk factors.
Methods: Data of 203 patients with PUP admitted to Maharaj Nakorn Chiangmai Hospital from January 2001 to October 2004 were studied retrospectively. General health data and data of twelve relevant risk factors were collected. The risk factors were analyzed by chi-squared test.
Results: The overall morbidity rate was 21.2% and mortality rate was 12.8%. Risk factors significantly associated with high mortality were age over 60 years, patient with underlying diseases (hypertension, diabetes mellitus, COPD, renal insufficiency, CHF, IHD, CA lung), duration from abdominal pain to operation more than 12 hours, hypotension before surgery, perforated size larger than 0.5 cm, and severe degree of contamination. The mean hospital stay was 8.64 days and number of patients who stayed more than 8 days was 50 (24.6%). Risk factors significantly associated with increasing hospital stay of more than 8 days were similar to those predicting mortality.
Conclusion: This study showed clearly that the duration before operation and hypotension were associated with high mortality and morbidity. Surgeons should modify these risk factors before surgery or referral.
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