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Predictors of Mortality in Gastroduodenal Ulcer Perforation: A Single Tertiary Care Center Study

Sneha Angadi , Bhavuray Teli1 , Sneha Angadi2 , Bhimangouda Goudar3 , Suhas B S4

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New Indian Journal of Surgery 11(4):p 457-461, October-December 2020. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.11420.2

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Bhavuray Teli, Sneha Angadi, Bhimangouda Goudar, et al. Predictors of Mortality in Perforated Gastroduodenal Ulcer
Perforation: A Single Tertiary Care Center Study. New Indian J Surg. 2020;11(4):457–461.
 

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Background: Gastroduodenal ulcer perforation (GDUP) is one of the most common emergencies which requires surgery. Even with the introduction of H2 receptor antagonists and proton pump inhibitors, the incidence of elective surgery for peptic ulcer diseases have been decreased, although complications of peptic ulcer remained fairly constant and perforation of peptic ulcer associated with significant morbidity and mortality. Aims and Objectives: The purpose of this study was to identify the risk factors that predict the mortality in Gastro duodenal ulcer perforation. Methdology: 226 patients underwent surgery for GDUP in S Nijalingappa Medical College (SNMC) and HSK Hospital and Research Centre, Bagalkot were studied retrospectively from January 2015 to December 2019. The following factors were analysed: age; gender; associated medical illness; chronic ingestion of NSAIDs; pre-operative shock; delay in surgery (>24 hours); site and size of ulcer perforation and type of peritoneal contamination were relating to cause of mortality. Results: Out of 226 patients, were 148 males and 78 were females. Gastric perforation was seen in 36 patients and duodenal perforation in 190.Postoperative death occurred in 15 patients, rest recovered well. In these 15 patients, onset of symptoms >24 hours, history of NSAIDS, preoperative shock and treatment delay (>24hours), large perforated ulcer size in all these factors, the p value is significant (p<0.05). Use of corticosteroids and co morbidities seen in these patients were 73.3 and 80% respectively (p<0.001). Conclusion: Elderly, delayed presentation, preoperative shock, high grade peritoneal contamination, large perforated ulcer size, co-morbidities, long term use of steroids and NSAIDS are the main factors which increased the mortality.

Keywords: Gastro duodenal ulcer perforation; Mortality; Shock; Peptic ulcer; Peritoneal contamination; Omental patch.

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Bhavuray Teli, Sneha Angadi, Bhimangouda Goudar, et al. Predictors of Mortality in Perforated Gastroduodenal Ulcer
Perforation: A Single Tertiary Care Center Study. New Indian J Surg. 2020;11(4):457–461.
 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.11420.2

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