title: Analysis of risk factors for postoperative morbidity in perforated peptic ulcer.
abstract: OBJECTIVE
  Emergency operations for perforated peptic ulcer are associated with a high incidence of postoperative complications. While several studies have investigated the impact of perioperative risk factors and underlying diseases on the postoperative morbidity after abdominal surgery, only a few have analyzed their role in perforated peptic ulcer disease. The purpose of this study was to determine any possible associations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer.
  
  
  METHODS
  In total, 142 consecutive patients, who underwent surgery for perforated peptic ulcer, at a single institution, between January 2005 and October 2010 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively.
  
  
  RESULTS
  The postoperative morbidity rate associated with perforated peptic ulcer operations was 36.6% (52/142). Univariate analysis revealed that a long operating time, the open surgical method, age (≥60), sex (female), high American Society of Anesthesiologists (ASA) score and presence of preoperative shock were significant perioperative risk factors for postoperative morbidity. Significant comorbid risk factors included hypertension, diabetes mellitus and pulmonary disease. Multivariate analysis revealed a long operating time, the open surgical method, high ASA score and the presence of preoperative shock were all independent risk factors for the postoperative morbidity in perforated peptic ulcer.
  
  
  CONCLUSIONS
  A high ASA score, preoperative shock, open surgery and long operating time of more than 150 minutes are high risk factors for morbidity. However, there is no association between postoperative morbidity and comorbid disease in patients with a perforated peptic ulcer.
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Gyeongnam Regional Cancer Center, Institue of Health Sciences, Gyeongsang National University, Jinju, Korea.
authors.forename: Jae-Myung
authors.initials: JM
authors.lastname: Kim
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Jeong
authors.forename: Young-Joon
authors.initials: YJ
authors.lastname: Lee
authors.forename: Soon-Tae
authors.initials: ST
authors.lastname: Park
authors.forename: Sang-Kyung
authors.initials: SK
authors.lastname: Choi
authors.forename: Soon-Chan
authors.initials: SC
authors.lastname: Hong
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Jung
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Ju
authors.forename: Chi-Young
authors.initials: CY
authors.lastname: Jeong
authors.forename: Woo-Song
authors.initials: WS
authors.lastname: Ha