J Gastric Cancer.  2012 Mar;12(1):26-35.

Analysis of Risk Factors for Postoperative Morbidity in Perforated Peptic Ulcer

• Kim JM
• Jeong SH
• Lee YJ
• Park ST
• Choi SK
• Hong SC
• Jung EJ
• Ju YT
• Jeong CY
• Ha WS

Abstract

PURPOSE
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.
MATERIALS AND 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 (> or =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.

Keyword

Peptic ulcer; Peptic ulcer perforation; Septic shock; Health status index

MeSH Terms

Diabetes Mellitus
Emergencies
Health Status Indicators
Humans
Hypertension
Incidence
Lung Diseases
Multivariate Analysis
Peptic Ulcer
Peptic Ulcer Perforation
Postoperative Complications
Risk Factors
Shock
Shock, Septic

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