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[Prognostic risk factors in patients operated on for perforated peptic ulcer. A retrospective analysis of critical factors of mortality and morbidity in a series of 40 patients who underwent simple closure surgery].
Ann Ital Chir. 1996 Sep-Oct; 67(5):609-13.AI

Abstract

STUDY OBJECTIVE

To identify factors affecting mortality and morbidity in patients operated on for perforated peptic ulcer.

DESIGN

Retrospective analysis.

SETTING

University Hospital, Italy.

PATIENTS

Forty patients consecutively operated on for perforated peptic ulcer by simple suture procedure performed either by laparotomy (n = 26) or laparoscopic (n = 14) approach.

MEASUREMENTS AND MAIN RESULTS

Mortality was 20% (n = 8) and morbidity in survivors was 25% (n = 8). Compared to survivors, non-survivors were older (mean age 79.3 yrs. vs 60.0 yrs., p < 0.01), had worse APACHE II and SAPS scores (mean 20.1 vs 8.5, p < 0.001; and 13.1 vs. 5.5, p < 0.0001 respectively), were treated later (mean interval from outbreak of symptoms to surgery 30.8 hrs. vs. 11.1 hrs., p < 0.01), and the size of their perforation was larger (mean 15.1 mm. vs. 8.6 mm, p < 0.05). The laparoscopic approach was the only factor that significantly was associated with morbidity in survivors (p < 0.01). The presence of at least two risk factors, enhanced the probability of death.

CONCLUSION

Old age, great APACHE II and SAPS scores, delay in treatment and large size of the perforation were associated significantly to mortality in perforated peptic ulcer patients. Efforts should be made perioperatively for patients having these risk factors.

Authors+Show Affiliations

Dipartimento di Chirurgia, Università degli Studi di Pisa.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ita

PubMed ID

9036818

Citation

Chiarugi, M, et al. "[Prognostic Risk Factors in Patients Operated On for Perforated Peptic Ulcer. a Retrospective Analysis of Critical Factors of Mortality and Morbidity in a Series of 40 Patients Who Underwent Simple Closure Surgery]." Annali Italiani Di Chirurgia, vol. 67, no. 5, 1996, pp. 609-13.
Chiarugi M, Buccianti P, Goletti O, et al. [Prognostic risk factors in patients operated on for perforated peptic ulcer. A retrospective analysis of critical factors of mortality and morbidity in a series of 40 patients who underwent simple closure surgery]. Ann Ital Chir. 1996;67(5):609-13.
Chiarugi, M., Buccianti, P., Goletti, O., Decanini, L., Sidoti, F., & Cavina, E. (1996). [Prognostic risk factors in patients operated on for perforated peptic ulcer. A retrospective analysis of critical factors of mortality and morbidity in a series of 40 patients who underwent simple closure surgery]. Annali Italiani Di Chirurgia, 67(5), 609-13.
Chiarugi M, et al. [Prognostic Risk Factors in Patients Operated On for Perforated Peptic Ulcer. a Retrospective Analysis of Critical Factors of Mortality and Morbidity in a Series of 40 Patients Who Underwent Simple Closure Surgery]. Ann Ital Chir. 1996 Sep-Oct;67(5):609-13. PubMed PMID: 9036818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Prognostic risk factors in patients operated on for perforated peptic ulcer. A retrospective analysis of critical factors of mortality and morbidity in a series of 40 patients who underwent simple closure surgery]. AU - Chiarugi,M, AU - Buccianti,P, AU - Goletti,O, AU - Decanini,L, AU - Sidoti,F, AU - Cavina,E, PY - 1996/9/1/pubmed PY - 1996/9/1/medline PY - 1996/9/1/entrez SP - 609 EP - 13 JF - Annali italiani di chirurgia JO - Ann Ital Chir VL - 67 IS - 5 N2 - STUDY OBJECTIVE: To identify factors affecting mortality and morbidity in patients operated on for perforated peptic ulcer. DESIGN: Retrospective analysis. SETTING: University Hospital, Italy. PATIENTS: Forty patients consecutively operated on for perforated peptic ulcer by simple suture procedure performed either by laparotomy (n = 26) or laparoscopic (n = 14) approach. MEASUREMENTS AND MAIN RESULTS: Mortality was 20% (n = 8) and morbidity in survivors was 25% (n = 8). Compared to survivors, non-survivors were older (mean age 79.3 yrs. vs 60.0 yrs., p < 0.01), had worse APACHE II and SAPS scores (mean 20.1 vs 8.5, p < 0.001; and 13.1 vs. 5.5, p < 0.0001 respectively), were treated later (mean interval from outbreak of symptoms to surgery 30.8 hrs. vs. 11.1 hrs., p < 0.01), and the size of their perforation was larger (mean 15.1 mm. vs. 8.6 mm, p < 0.05). The laparoscopic approach was the only factor that significantly was associated with morbidity in survivors (p < 0.01). The presence of at least two risk factors, enhanced the probability of death. CONCLUSION: Old age, great APACHE II and SAPS scores, delay in treatment and large size of the perforation were associated significantly to mortality in perforated peptic ulcer patients. Efforts should be made perioperatively for patients having these risk factors. SN - 0003-469X UR - https://www.unboundmedicine.com/medline/citation/9036818/[Prognostic_risk_factors_in_patients_operated_on_for_perforated_peptic_ulcer__A_retrospective_analysis_of_critical_factors_of_mortality_and_morbidity_in_a_series_of_40_patients_who_underwent_simple_closure_surgery]_ DB - PRIME DP - Unbound Medicine ER -