Preoperative and intraoperative factors affecting mortality in patients operated on for peptic ulcer perforation: a single center retrospective study

Abstract

Aim: Peptic ulcer perforation (PUP) is currently the most common complication of peptic ulcer disease (PUD), which requires surgery. Mortality and morbidity rates are high after surgical treatment. The aim of this study was to determine the predictive factors affecting postoperative mortality in patients undergoing surgery due to peptic ulcer perforation.
 Methods: The study included 135 patients diagnosed and operated on because of PUP in the general surgery clinic between February 2015 and January 2020. Evaluations were made of the relationships between mortality and age, gender, ASA scores, season of surgery, preoperative leukocyte, preoperative neutrophil to lymphocyte ratio (NLR), preoperative creatinine and amylase values, location and diameter of the perforation, comorbid diseases, onset of pain and time of surgery.
 Results: Advanced age, male gender, high ASA score, >12 hours between the onset of the symptoms and the time of surgery, and high creatinine, NLR and amylase values before surgery, ulcer diameter >1 cm and comorbid diseases were associated with mortality. No relationship was found between the location of the ulcer and leukocyte values at the time of admission and mortality.
 Conclusion: Advanced age, male gender, high ASA score, >12 hours between the onset of symptoms and the time of surgery, and high preoperative creatinine, NLR and amylase values, ulcer diameter >1 cm and comorbid diseases are risk factors for mortality in peptic ulcer perforation. Understanding these factors, identifying patients at risk, and early intervention can help reduce mortality in PUP.