title: Factors associated with postoperative complications and mortality in perforated peptic ulcer.
abstract: BACKGROUND
  Elective surgery for uncomplicated peptic ulcer has shown a significant decrease; however, complications such as perforation and obstruction persist and require urgent surgical management. The aim of this study was to identify factors associated with early postoperative complications and mortality of patients admitted to the emergency department with perforated peptic ulcer.
  
  
  METHODS
  We performed a clinical, retrospective, cross-sectional and descriptive study of patients who were treated at the General Hospital of Mexico with a diagnosis of perforated peptic ulcer from January 2006 to December 2008. Thirty patients were included in the study. We studied several clinical findings upon admission to the emergency department and intraoperative patient findings in order to determine the association of those with early postoperative complications and mortality.
  
  
  RESULTS
  We studied 30 patients with an average age of 57.07 years (± 14.2 years). The male:female ratio was 2:1. We found that the risk of developing postoperative complications was 66.7% and is significantly influenced by time of onset of abdominal pain prior to admission, bloating, septic shock and blood type O positive. Mortality was 16.7% and was correlated with the presence of septic shock on admission. The surgical procedure performed was primary closure with Graham patch in 86.6%. Average hospital stay was 12.8 days.
  
  
  CONCLUSIONS
  The presence of early postoperative complications is associated with time of onset of abdominal pain before admission, abdominal distension, blood type O positive and the presence of septic shock on admission.
authors.affiliation: Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico. montalvoeduardo@hotmail.com
authors.forename: Eduardo Esteban
authors.initials: EE
authors.lastname: Montalvo-Javé
authors.forename: Omar
authors.initials: O
authors.lastname: Corres-Sillas
authors.forename: César
authors.initials: C
authors.lastname: Athié-Gutiérrez
mesh_terms: D000017:ABO Blood-Group System / Q000032:analysis; D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004380:Duodenal Obstruction / Q000209:etiology; D004381:Duodenal Ulcer / Q000401:mortality / Q000601:surgery; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000209:etiology / Q000401:mortality; D013276:Stomach Ulcer / Q000401:mortality / Q000601:surgery; D013997:Time Factors; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System