Imhof Michael, Epstein Stefan, Ohmann Christian, Röher Hans-Dietrich
Department of General and Trauma Surgery, Malteser Hospital St. Hildegardis, Bachemer Str. 29-33, 50931 Cologne, Germany.
World J Surg. 2008 Mar;32(3):408-12. doi: 10.1007/s00268-007-9370-2.
The long-term course after peptic ulcer perforation is unclear, but because the ulcer population is generally older and has concomitant disease, the long-term prognosis may be expected to be poor.
In a study based on prospective data collection, all patients with peptic ulcer perforation treated at the Department of Surgery at the Heinrich-Heine-University in Dusseldorf, Germany, were documented between 1986 and 1995. In a follow-up study, the following parameters were investigated and survival rates were estimated: hospital mortality, 1-month mortality, 1-year mortality, and 5-year mortality. Significant prognostic parameters for death were worked out in univariate and multivariate analysis.
Ninety-nine out of 108 patients with peptic ulcer perforation could be followed-up. One-month mortality was similar to hospital mortality, at 9.1%; 1-year mortality was about 20.2%; and 5-year mortality was 32.3%. Statistically significant prognostic factors for death in univariate analysis were age beyond 70 years, concomitant diseases, risk-related drugs, postinterventional complications and admission status. In multivariate analysis concomitant diseases, postoperative complications, and advanced age were significant parameters for death.
Long-term prognosis of peptic ulcer perforation is poor. Risk factors for late mortality after peptic ulcer perforation are age, severe concomitant diseases, and postinterventional complications.
消化性溃疡穿孔后的长期病程尚不清楚,但由于溃疡患者群体普遍年龄较大且伴有其他疾病,预计其长期预后较差。
在一项基于前瞻性数据收集的研究中,对1986年至1995年间在德国杜塞尔多夫海因里希 - 海涅大学外科接受治疗的所有消化性溃疡穿孔患者进行了记录。在一项随访研究中,对以下参数进行了调查并估计了生存率:医院死亡率、1个月死亡率、1年死亡率和5年死亡率。通过单因素和多因素分析确定了死亡的显著预后参数。
108例消化性溃疡穿孔患者中有99例可进行随访。1个月死亡率与医院死亡率相似,为9.1%;1年死亡率约为20.2%;5年死亡率为32.3%。单因素分析中具有统计学意义的死亡预后因素为70岁以上年龄、伴发疾病、风险相关药物、介入后并发症和入院状态。多因素分析中,伴发疾病、术后并发症和高龄是死亡的显著参数。
消化性溃疡穿孔的长期预后较差。消化性溃疡穿孔后晚期死亡的危险因素为年龄、严重伴发疾病和介入后并发症。