Risk factors influencing morbidity and mortality in perforated peptic ulcer disease.
OBJECTIVE
Peptic ulcer perforation continues to be a major surgical problem. In this study, risk factors that influence morbidity and mortality in perforated peptic ulcer disease were examined.


METHODS
Files of 148 patients who were included in the study due to peptic ulcer perforation between January 2006 and December 2010 were retrospectively analyzed. Data regarding age, gender, complaints, time elapsed between onset of symptoms and hospital admission, physical examination findings, co-morbid diseases, laboratory and imaging findings, length of hospital stay, morbidity and mortality were recorded.


RESULTS
The study group included 129 (87.2%) male and 19 (12.8%) female patients. The mean age was 51.7±20 (15-88) years. Forty five patients (30.4%) had at least one co-morbid disease. In the postoperative period, 30 patients (20.3%) had complications. The most common complication was wound infection. Mortality was observed in 27 patients (18.2%). The most common cause of mortality was sepsis. Multivariate analysis revealed age over 60 years, presence of co-morbidities and Mannheim peritonitis index as independent risk factors for morbidity. Age over 60 years, time to admission and Mannheim peritonitis index were detected as independent risk factors for mortality.


CONCLUSIONS
Early diagnosis and proper treatment are important in patients presenting with peptic ulcer perforation.
Clinic of General Surgery, Ministry of Health Cizre State Hospital, Şırnak, Turkey.
İlhan
İ
Taş
Department of General Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Burak Veli
BV
Ülger
Department of General Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Akın
A
Önder
Department of General Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Murat
M
Kapan
Department of General Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Zübeyir
Z
Bozdağ
Peptic ulcer perforation; morbidity; mortality; risk factors; time to admission