SOME FACTORS ASSOCIATED WITH MORTALITY IN PERFORATED PEPTIC-ULCER - ACASE-CONTROL STUDY

This study examined the associations of individual coexisting illnesse s, septicaemia, intraabdominal abscess, marital status, smoking and al cohol use, with mortality following perforation of peptic ulcer withou t pre-operative evidence of haemorrhage. Patients who died in hospital following ulcer perforation (cases; n = 300) were compared with patie nts who survived following ulcer perforation (controls; n = 276) The c ontrols were frequency-matched to the cases on age, sex and perforatio n site. Data were analysed by logistic regression. Cardiac, respirator y, cerebrovascular, renal, liver and malignant diseases, and septicaem ia and intra-abdominal abscess were associated with mortality and the coexisting illnesses were significantly increased in cases compared to controls both on admission and at: the end of hospital stay. During h ospitalization, the odds of pneumonia decreased in cases, otherwise th ere was little change in strengths of associations over this period. B eing widowed or never married was positively associated with mortality , and moderate alcohol use was negatively associated. In conclusion, t his study identifies several coexisting illnesses, septicaemia and int ra-abdominal abscess as risk factors for mortality following ulcer per foration. The results suggest that, with little exception, the same le vel of mortality risk is associated with coexisting illnesses whether the beginning or end of hospital stay is used as the index time point.