Perforated peptic ulcer in southeastern Taiwan.
BACKGROUND
No studies focus on the population with perforated peptic ulcer in southeastern Taiwan. The present study aimed to assess the differences between the different races and the risk factors related to mortality and morbidity in postoperative patients in southeastern Taiwan.


METHODS
The medical records of 237 patients were reviewed retrospectively. The following factors were analyzed: patient profiles, coexisting illnesses, diagnostic method, fever, preoperative shock, clinical data at emergency room, delay operation, site of perforation, operative method, positive ascites culture, species of microbes in ascites culture, postoperative complications, death and the length of hospital stay.


RESULTS
Aborigines were significantly different from non-aborigines in the ratio of female cases and in the habits of alcohol drinking and betel nut chewing. There were also four significantly different variables between them: fever, hemoglobin value, site of perforation and operative method. Total postoperative complication rate was 41.3% and 39 patients (16.6%) died. In multivariate analysis, age > or = 65 years, lipase > upper normal limit and preoperative shock were independent predictors of mortality. Significant risk factors associated with morbidity were NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock.


CONCLUSIONS
Aborigines were different from non-aborigines in several categories. In southeastern Taiwan, NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock were independent risk factors of morbidity, and age > or = 65 years, lipase > upper normal limit and preoperative shock were independent risk factors of mortality in postoperative perforated peptic ulcer. Lipase > upper normal limit is needed for further research on the influence on mortality.
Li
Chin-Hsien
CH
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu Branch, Taiwan.
Chang
Wen-Hsiung
WH
Shih
Shou-Chuan
SC
Lin
Shee-Chan
SC
Bair
Ming-Jong
MJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000208:ethnology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001114:Areca / Q000009:adverse effects; D044466:Asian People / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D004381:Duodenal Ulcer / Q000208:ethnology* / Q000401:mortality / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008049:Lipase / Q000097:blood; D016015:Logistic Models; D008297:Male; D008409:Mastication / Q000208:ethnology; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000208:ethnology* / Q000401:mortality / Q000601:surgery*; D057234:Preoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012769:Shock / Q000208:ethnology / Q000401:mortality; D013276:Stomach Ulcer / Q000208:ethnology* / Q000401:mortality / Q000601:surgery*; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014628:Vagotomy / Q000009:adverse effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D006454:Hemoglobins; D003404:Creatinine; D008049:Lipase