[Perforated peptic ulcer--a 12-year material].

BACKGROUND

We aimed to explore patient characteristics, diagnostic and surgical procedures and results of treatment of perforated peptic ulcer at our hospital, and determine prognostic factors for death and postoperative complications.

MATERIAL AND METHODS

Data were collected retrospectively from 102 patients with perforated peptic ulcer identified from a broad case file search of 590 patients from 1992 to 2003. Prognostic factors for dead and post-operative complications were analysed using both uni- and multivariate analyses.

RESULTS

48 men and 54 women, median age 71 (25 - 94) were evaluated. Surgery was performed in 100 patients, 2 received conservative treatment. 55 patients had perforated gastric ulcers (including prepyloric ulcers), and 47 patients had perforated duodenal ulcers. Out of the 100 patients who underwent surgery, 22 died and 39 suffered postoperative complications. By univariate analysis, high age, high ASA score and a long interval between initial symptoms and surgery were significantly associated with death (p < 0.01) and postoperative complications (p < 0.05). By logistic regression, high age (OR 1.1; 95 % CI 1.0 - 1.2; p = 0.04) and high ASA classification (OR 6.7; 95 % CI 1.4 - 33; p = 0.02) predicted death, and high ASA classification predicted postoperative complications (OR 4.2; 95 % CI 1.7 - 10.2; p = 0.002).

INTERPRETATION

Perforated peptic ulcer is a disease with low incidence, high mortality and a high frequency of postoperative complications, mainly determined by the patient's age and ASA classification.