Evaluation of risk factors for mortality in perforated peptic ulcer in Ankara Numune Teaching Hospital, Ankara, Turkey.

OBJECTIVE: To assess the risk factor that influence mortality from perforated peptic ulcer.

DESIGN: Retrospective study.

SETTING: Ankara Numune Teaching and Research Hospital, Ankara, Turkey.

SUBJECTS: A total of 342 patients with perforated peptic ulcer disease were identified from April 1997 to January 2004. Data for the patients were extracted from the hospital records, operative notes and clinic charts.

MAIN OUTCOME MEASURES: Age, sex, coexisting medical illness, use of non-steroidal anti-inflammatory drugs (NSAID) or steroids, preoperative shock, delay in treatment location of ulcer size, type of operation time, albumin concentration postoperative complications, postoperative hospitals stay and mortality results for all patients were obtained.

RESULTS: Patients were aged from 17 to 80 years (mean 63 years, median 68 years) there were 210 males and 132 females. The mortality rate was 8.8% (30/342), and 62 patients had postoperative complications. Multivariate analysis showed that co-existing medical illness, preoperative shock, delay in treatment and low albumin concentrations were independent risk factors that significantly contributed to mortality.

CONCLUSION: This study confirms co-existing medical illness, preoperative shock, delay in treatment and low albumin concentration as significant risk factors that increase mortality in patients with perforated peptic ulcers. These factors could serve as a guide to opine the risk and to improve the outcome in patients with perforated peptic ulcer. Mortality could be reduced by preventing delay in diagnosis and treatment for any co-existing medical illness and providing appropriate nutrition support.