title: Results of surgery for perforated gastroduodenal ulcers in a Dutch population.
abstract: OBJECTIVE
  Despite improvements in anesthesiology and intensive care medicine, mortality for perforated gastroduodenal ulcer disease remains high. This study was designed to evaluate the results of surgery for perforated ulcer disease and to identify prognostic factors for mortality in order to optimize treatment.
  
  
  METHODS
  The medical records of 272 patients undergoing emergency surgery for perforated ulcer disease from 2000 to 2005 in two large teaching hospitals and one university hospital in the Netherlands were retrospectively analyzed. Information on 89 pre-, peri- and postoperative data were recorded. Statistical analysis was performed using multiple logistic regression analysis. The primary endpoint was 30-day mortality.
  
  
  RESULTS
  The 30-day mortality rate was 16%. Variables associated with 30-day mortality were age, shock, tachycardia, anemia and ASA class.
  
  
  CONCLUSIONS
  A relatively low 30-day mortality rate was achieved. Age, shock, tachycardia and anemia were significantly associated with 30-day mortality. Finding that shock, tachycardia and anemia are independently associated with 30-day mortality could indicate that patients are septic upon admission. Improvements in survival might be achieved by early sepsis treatment.
authors.affiliation: Department of Surgery, Leeuwarden Medical Center, Leeuwarden, The Netherlands. p.h.j.hemmer@umcg.nl
authors.forename: P H J
authors.initials: PH
authors.lastname: Hemmer
authors.forename: J S
authors.initials: JS
authors.lastname: de Schipper
authors.forename: B
authors.initials: B
authors.lastname: van Etten
authors.forename: J P E N
authors.initials: JP
authors.lastname: Pierie
authors.forename: J J
authors.initials: JJ
authors.lastname: Bonenkamp
authors.forename: P W
authors.initials: PW
authors.lastname: de Graaf
authors.forename: T M
authors.initials: TM
authors.lastname: Karsten
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000150:complications / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D012189:Retrospective Studies; D012769:Shock / Q000150:complications; D013276:Stomach Ulcer / Q000150:complications / Q000601:surgery*; D013610:Tachycardia / Q000150:complications; D055815:Young Adult