Abstract
Introduction Peptic ulcer is an important health problem worldwide with a prevalence of around 5%. Peptic ulcer perforation is a potentially mortal complication of peptic ulcer disease. We aimed to investigate the potential use of red cell distribution width as a prognostic marker in peptic ulcer perforation. Methods The files, operation notes, biochemical and hematological parameters, and prognosis of patients who were operated for a peptic ulcer perforation were reviewed in a retrospective cohort study. The relation of red cell distribution width (RDW) to main outcome in-hospital mortality was assessed. Results The mean age of the 172 patients was 40 ± 17.89. There were 158 (92%) males and 14 (8%) females. The in-hospital mortality was 8.7% (15/172). The median RDW in the group with mortality was 15.00 (interquartile range (IQR): 14.30–17.20) compared with the median RDW in the group with no mortality as 13.2 (IQR: 12.80–14.00, p ≤ 0.001). Receiver operator characteristic curves were plotted for RDW to identify nonsurvivors and yielded a significant area under the curve as 0.812 (95% confidence interval: 0.682–0.942). The sensitivity and specificity of RDW at a cutoff value of 14.25% were calculated with an accuracy of 81.98 (95% confidence interval: 75.40–87.41) as 80.00 (51.91–95.67) and 82.17 (75.27–87.81), respectively. Conclusion Increased RDW may be of use to interpret mortality in patients with peptic ulcer perforation.
Highlights
Peptic ulcer is an important health problem worldwide with a prevalence of around 5%
red cell distribution width (RDW) is obtained during routine complete blood count (CBC) lab testing, and accumulating evidence demonstrates that RDW is a valuable prognostic tool in multiple disease settings
We evaluated the in-hospital mortality of patients receiving surgery for Peptic ulcer perforation (PUP) at the General Surgery Department of Istanbul Haseki Training and Research Hospital in a retrospective cohort study. e medical records of patients who underwent emergency surgery for PUP between May 2013 and May 2017 were reviewed according to codes designated by the International Statistical Classification of Diseases and Related Health Problems, 11th revision. is study was approved by the local ethical committee (195/26.07.2018) and conformed to the principles of the Declaration of Helsinki
Summary
Peptic ulcer is an important health problem worldwide with a prevalence of around 5%. Peptic ulcer perforation is a potentially mortal complication of peptic ulcer disease. We aimed to investigate the potential use of red cell distribution width as a prognostic marker in peptic ulcer perforation. E relation of red cell distribution width (RDW) to main outcome in-hospital mortality was assessed. Increased RDW may be of use to interpret mortality in patients with peptic ulcer perforation. Peptic ulcer perforation (PUP) is a serious complication of peptic ulcer disease (PUD) that causes morbidity and mortality. E lifetime prevalence of perforation in patients with PUD is reported to be around 5% [1]. Due to its relatively common occurrence, identification of patients at a greater risk of mortality at earlier stages would result in better allocation of resources regarding intensive care and transportation and earlier medical intervention. RDW is obtained during routine complete blood count (CBC) lab testing, and accumulating evidence demonstrates that RDW is a valuable prognostic tool in multiple disease settings
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