Purpose: Despite modern medication, peptic ulcer, patients often require emergency surgery for complications of peptic ulcer disease, and the mortality due to a perforated peptic ulcer still remains high. This retrospective study was conducted to evaluate the risk factors associated with mortality in patients undergoing surgery for a perforated peptic ulcer.
Methods: Two hundred and four consecutive patients (mean age: 45.8 years; range: 15～90 years) who underwent emergency surgery for a perforated peptic ulcer at the National Medical Center, between January 1991 and December 2000, were reviewed.
Results: The overall mortality rate was 5.9%. A univariate analysis of multiple clinical variables revealed old age (≥65 years), duration of symptoms (≥24 hours), NSAIDs or steroid use, comorbid disease, shock on admission, low hemoglobin (＜10 g/dl), higher BUN (≥20 mg%), higher creatinine (≥1.5 mg%), gastric ulcer and simple closure to be significantly associated with mortality. However, a multivariate analysis showed that shock on admission, comorbid disease and old age (≥65 years) were independent predictors of mortality.
Conclusion: Shock on admission, comorbid disease and old age should be considered as significant prognostic factors of emergency surgery for a perforated peptic ulcer, and a comorbid disease and age as non modifiable factors. For that reason, prompt resuscitation is considered as the most effective therapy for reducing the mortality due to peptic ulcer perforation. (J Korean Surg Soc 2004;67:373-378)
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