Risk factors predicting morbidity and mortality in perforated peptic ulcer: clinical experience in Loei hospital. Difference from the past
Keywords:
perforated peptic ulcer, Loei hospitalAbstract
Background: The goal of this study is to identify risk factors predicting the morbidity and mortality of peptic ulcer perforation (PPU), morbidity and mortality of simple suture with or without omental graft in Loei hospital compare with overall morbidity and mortality, incidence of gastric cancer perforation and recurrent rate
Methods: A retrospective study of 107 patients undergoing emergency surgery of PPU between 1st May 2012 – 30th June 2014 in Loei hospital. All patient was undergone simple suture with or without omental graft .Clinical presentations, investigation and surgical outcomes were analyzed. Follow up patient up to 2 years to predict recurrent rate.
Results: The study included 107 patients with average age of 58.8 years (range: 25- 86) and 90% were male, the most common type was type V. Overall morbidity rate was 15% and the mortality rate was 4.7%. The risk factors predicted morbidity and mortality were ASA Class III-IV, pre-op shock, renal failure, anemia and ulcer size ≥5 mm. Pathologic reported negative for malignancy in all patients. In 5.4% of patient had suffer from non heal ulcer after treatment with operation with H.Pylori eradication plus proton pump inhibitor drugs at least 6 week. Mean follow up patient was 27.7 week (0-116 week), no patient had recurrent symptom.
Conclusions: The risk factors predicted morbidity and mortality were ASA Class III-IV, pre-op shock, renal failure, anemia and ulcer size ≥5 mm. To improve outcome of treatment we should defined patient into high or low risk for proper treatment. Primary closure of the perforation was safe in emergency setting.
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การละเมิดลิขสิทธิ์ถือเป็นความรับผิดชอบของผู้ส่งบทความโดยตรง
ผลงานที่ได้รับการตีพิมพ์ถือเป็นลิขสิทธิ์ของผู้นิพนธ์ ขอสงวนสิทธิ์มิให้นำเนื้อหา ทัศนะ หรือข้อคิดเห็นใด ๆ ของบทความในวารสารไปเผยแพร่ทางการค้าก่อนได้รับอนุญาตจากกองบรรณาธิการ อย่างเป็นลายลักษณ์อักษร
