Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer.
OBJECTIVE
To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city.


METHODS
One hundred and forty-nine consecutive patients (M:F ratio=110:39, mean age 52 yrs, range 16-95) with peptic ulcer disease were investigated for clinical history (including age, sex, previous history of peptic ulcer, associated diseases, delayed abdominal surgery, ulcer site, operation type, shock on admission, postoperative general complications, and intra-abdominal and/or wound infections), serum analyses and radiological findings.


RESULTS
The overall mortality rate was 4.0%. Among all factors, an age above 65 years, one or more associated diseases, delayed abdominal surgery, shock on admission, postoperative abdominal complications and/or wound infections, were significantly associated (chi2) with increased mortality in patients undergoing surgery (0.0001<P<0.03).


CONCLUSIONS
Factors such as concomitant diseases, shock on admission, delayed surgery, and postoperative abdominal and wound infections are significantly associated with fatal outcomes and need careful evaluation within the general workup of patients admitted for perforated peptic ulcer.
Testini
Mario
M
Section of General Surgery and Vascular Surgery and Clinical Oncology, Department of Applications in Surgery of Innovative Technologies (DACTI), University Medical School, Bari, Italy. mario.testini@tin.it
Portincasa
Piero
P
Piccinni
Giuseppe
G
Lissidini
Germana
G
Pellegrini
Fabio
F
Greco
Luigi
L
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000401:mortality* / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D012017:Referral and Consultation; D012307:Risk Factors; D012769:Shock / Q000401:mortality / Q000601:surgery; D013997:Time Factors