Preoperative factors influencing mortality and morbidity in peptic ulcer perforation.

Purpose: Perforated peptic ulcer is one of the most common surgical emergencies worldwide. With the improvement in medical therapy for peptic ulcers, the number of elective surgical procedures has come down. However, the incidence of perforated peptic ulcer is still increasing and remains as a subst...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 44; no. 2; pp. 251 - 258
Autores principales: Sivaram, P., Sreekumar, A.
Formato: research Journal Article
Publicado: Springer Nature Apr2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2018
      vid: 44
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-017-0777-7
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        atl: Preoperative factors influencing mortality and morbidity in peptic ulcer perforation.
      aug:
        au:
          Sivaram, P.
          Sreekumar, A.
        affil: Department of General Surgery, Government Medical College, 695011, Thiruvananthapuram, India
      sug:
        subj:
          Peptic Ulcer Perforation Mortality
          Morbidity
          Peptic Ulcer
          Intestinal Perforation
          Peritonitis
          Risk Assessment
          Human
          Prospective Studies
          Nonexperimental Studies
          Time Factors
          Female
          Male
          Preoperative Period
          Female
          Male
      ab: Purpose: Perforated peptic ulcer is one of the most common surgical emergencies worldwide. With the improvement in medical therapy for peptic ulcers, the number of elective surgical procedures has come down. However, the incidence of perforated peptic ulcer is still increasing and remains as a substantial health problem with significant postoperative morbidity and mortality. This study aimed to find out the association between various preoperative and intraoperative factors with the postoperative mortality and morbidity in patients operated for peptic ulcer perforation.Methods: This prospective observational study had a time based sample of 101 perforation peritonitis cases admitted to the surgical wards of a tertiary care center from February 2015 to January 2016 who underwent laparotomy, diagnosed to have peptic ulcer perforation and underwent simple closure with an omental patch. Data regarding age, gender, presenting complaints, time elapsed from the onset of symptoms to surgery, physical examination findings, comorbid diseases, laboratory and imaging findings, intraoperative findings, length of hospital stay, postoperative morbidity, and mortality were recorded and analyzed.Results: Female gender, older age group, perforation surgery interval more than 36 h, and size of perforation more than 1 cm2 were found to be significant factors influencing postoperative mortality and morbidity. Postoperative morbidity was also associated with comorbid diseases. Abnormal renal function on presentation was identified as an additional risk factor for postoperative morbidity and longer hospital stay.Conclusions: An understanding of these factors, identification of patients at risk and early intervention can help in reducing the postoperative morbidity and mortality in peptic ulcer perforation.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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