Complications of peptic ulcer disease before and after the introduction of H2-receptor antagonists.

This study was undertaken in order to evaluate the incidence of operations for bleeding, perforated and obstructing peptic ulcers in a defined population before and after the introduction of H2-receptor antagonists. The annual incidence of surgery for all peptic ulcer complications increased slightly, from 6.9 per 10(5) individuals in 1977 to 14.2 per 10(5) in 1989 (n.s.), whereas the annual incidence of operations for ulcer bleeding and perforation remained relatively stable, varying from 2.8 to 8.9 per 10(5) inhabitants and from 2.3 to 7.5 per 10(5) inhabitants during the study period. Operations performed for gastric outlet obstruction did not increase, varying from 0.8 to 2.2 per 10(5) individuals over the study period. The annual proportion of emergency operations did not increase. Young men and old women were often operated on for bleeding (p less than 0.0001) and perforated ulcers (p less than 0.01). Duodenal ulcer bleeding and perforation were more frequent in the young patient groups. Overall mortality after operations performed for bleeding was 15%, and that after operations for perforation or obstruction, 17% and 8%, respectively. The mean age of the fatalities, 63 +/- 13 years, was significantly higher than that of those who survived after operation, 53 +/- 15 years (p 0.0001). Mortality was higher after operations for gastric ulcer complications (22%) than after operations for duodenal ulcer complications (10%) (p less than 0.01).