title: Incidence and short-term mortality from perforated peptic ulcer in Korea: a population-based study.
abstract: BACKGROUND
  Perforated peptic ulcer (PPU) is associated with serious health and economic outcomes. However, few studies have estimated the incidence and health outcomes of PPU using a nationally representative sample in Asia. We estimated age- and sex-specific incidence and short-term mortality from PPU among Koreans and investigated the risk factors for mortality associated with PPU development.
  
  
  METHODS
  A retrospective population-based study was conducted from 2006 through 2007 using the Korean National Health Insurance claims database. A diagnostic algorithm was derived and validated to identify PPU patients, and PPU incidence rates and 30-day mortality rates were determined.
  
  
  RESULTS
  From 2006 through 2007, the PPU incidence rate per 100 000 population was 4.4; incidence among men (7.53) was approximately 6 times that among women (1.24). Incidence significantly increased with advanced age, especially among women older than 50 years. Among 4258 PPU patients, 135 (3.15%) died within 30 days of the PPU event. The 30-day mortality rate increased with advanced age and reached almost 20% for patients older than 80 years. The 30-day mortality rate was 10% for women and 2% for men. Older age, being female, and higher comorbidity were independently associated with 30-day mortality rate among PPU patients in Korea.
  
  
  CONCLUSIONS
  Special attention should be paid to elderly women with high comorbidity who develop PPU.
authors.affiliation: Health Insurance Review and Assessment Service, Research and Development Center, Seoul, South Korea.
authors.forename: Seungjin
authors.initials: S
authors.lastname: Bae
authors.forename: Ki-Nam
authors.initials: KN
authors.lastname: Shim
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.forename: Jung Mook
authors.initials: JM
authors.lastname: Kang
authors.forename: Dong-Sook
authors.initials: DS
authors.lastname: Kim
authors.forename: Kyoung-Min
authors.initials: KM
authors.lastname: Kim
authors.forename: Yu Kyung
authors.initials: YK
authors.lastname: Cho
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Jung
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000453:epidemiology* / Q000401:mortality; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors