Risk Factors of Surgical Management of Peptic Ulcer Perforation: 2-Year Study at Maharat Nakhon Ratchasima Hospital

Abstract

Background: Peptic ulcer perforation is a common complication of peptic ulcer disease. It has a major impact in health care systemand and is always interesting for the surgeons. Objective: To evaluate the morbidity, mortality, and operative risk factor in perforated peptic ulcer patients at Maharat Nakhon Ratchasima Hospital. Patients and Methods: Retrospective analytic study was performed in 359 perforated peptic ulcer patients those were operated in Maharat Nakhon Ratchasima Hospital, during January, 2000 and December, 2001. Results: The morbidity rate was 15.6%, 7.2% wound complication and 7.0% pulmonary complication. The mortality rate was 6.4%. Female, age > 60 years, duration of perforation = or > 48 hours, and preoperative shock were significant factors associated with morbidity and mortality. There was no difference in mortality rate between perforated gastric ulcer patients and perforated duodenal ulcer patients. However, morbidity was greater in perforated gastric ulcer patients than in perforated duodenal ulcer patients. Operative procedures did not result in different morbidity rate, but simple suture was more significantly associated with mortality than the definitive one. Conclusion: Operative risk factors significantly related to morbidity and mortality were female, age > 60 years, duration of perforation = or > 48 hours, and preoperative shock. Type of peptic ulcer perforation did not differ in mortality but morbidity. The morbidity is higher in perforated gastric ulcer patients than in perforated duodenal ulcer patients. We found no difference in morbidity between definitive procedure and simple suture.