Risk factors of mortality in perforated peptic ulcer

Objective: To assess the risk factors that influence mortality from perfora ted peptic ulcer. Design: Retrospective study. Setting: General hospital, Taiwan. Subjects: 179 patients who had their perforated peptic ulcers operated on a nd who had minimum follow-up of one year. Main outcome measures: Mortality. Results: The overall mortality was 15% (26/179). Of the 26 patients who die d, the cause of death was uncontrolled systemic infection in 21 (81%), hypo volaemic shock in 2, and fatal arrhythmia and heart failure in 1 each. 15 o f the patients who died of sepsis did not have fulminant abdominal sepsis. Most deaths occurred early after operation, (range 1-96 days). Old age, pre operative shock, and type of operation seemed to be related to these deaths on univariate analysis, but multivariate analysis showed that coexisting m edical illness, delayed treatment, and low albumin concentration were indep endent risk factors for mortality. Conclusions: To improve the result of treatment of perforated peptic ulcer, the diagnosis and treatment should not be delayed, the associated medical illnesses should be treated, and nutritional support should be given.