SURVIVAL AFTER PEPTIC-ULCER PERFORATION - A TIME TREND ANALYSIS

The survival of 1098 patients with ulcer perforation in Norway during the period 1952-1990 was compared with expected survival. Cox regressi on models incorporating population mortality rates, were used to analy se effects of sex, age, year of birth, and year at risk on excess mort ality. Survival was lower in patients than in the general population t hrough a follow up period of 38 years. Relative survival was lower in women as compared to men, due to more delayed treatment. Long-term sur vival was lower after praepyloric perforations than after the other pe rforation types. Relative survival was higher in patients treated 1952 -1970 than in those treated more recently. However, adjustment for yea r of birth revealed a decline in short-term mortality with calendar ti me, which is in accordance with improved management during the study p eriod. Relative mortality, particularly long term mortality, was highe r in younger birth cohorts, suggesting a shift towards more serious et iologies. Copyright (C) 1996 Elsevier Science Inc.