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Perforated Peptic Ulcer Disease in a Tertiary Hospital, Addis Ababa, Ethiopia: Five Year Retrospective Study
Henok Teshome1, Mekbib Birega2, Mekdim Taddese1
1Assistant Professor of Surgery, St. Paul's Hospital Millennium Medical College (SPHMMC).
Insights
Perforated peptic ulcer disease (PPUD) significantly impacts patients, with older age, female sex, comorbidities, and delayed presentation increasing postoperative complications and mortality risks.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Public Health
Background:
- Peptic ulcer perforation is a critical complication of peptic ulcer disease.
- It is associated with substantial morbidity and mortality.
- Understanding risk factors is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze patient presentation, management, and postoperative complications of perforated peptic ulcer disease (PPUD).
- To identify factors influencing postoperative outcomes in PPUD patients.
- To evaluate the impact of various clinical factors on morbidity and mortality.
Main Methods:
- Retrospective review of 136 patients operated on for PPUD between January 2013 and December 2017.
- Univariate analysis was employed to assess the influence of patient and operative factors.
- Data collected included patient demographics, symptom onset, perforation site, and postoperative complications.
Main Results:
- Males (5.5:1 ratio) predominated; mean age was 36.05 years.
- 52.2% presented after 24 hours; 86% had duodenal perforations.
- Postoperative complications occurred in 22.8% of patients. Old age, female sex, comorbidities, hypotension, tachycardia, and delayed presentation were linked to increased morbidity (P<0.05).
- Mortality was 6.6%; associated with old age, comorbidities, tachycardia, and complications (P<0.05).
- Patients with complications had longer hospital stays (18.6 days vs. 6.7 days, P=0.001).
Conclusions:
- Old age, female sex, comorbidities, hypotension, tachycardia, and delayed presentation are significant predictors of postoperative morbidity in PPUD.
- Increased risk of mortality is associated with old age, comorbid illness, tachycardia, and postoperative complications.
- Timely intervention and management of risk factors are essential for reducing PPUD-related adverse outcomes.
Background:
Peptic ulcer perforation is one of the two major acute complications of peptic ulcer disease with significant morbidity and mortality.
Methods:
Institution based retrospective review was done to determine patient presentation, management and postoperative complications of perforated peptic ulcer disease (PPUD) at a tertiary hospital in Addis Ababa, Ethiopia. Patients operated on from January 2013 to December 2017 were included. Univalent analysis was used to determine the influence of patient and operative events on postoperative outcomes.
Result:
Totally, 136 patients were studied. Males outnumbered females by a ratio of 5.5:1. The mean age of patients was 36.05±16.56 years. Seventy-one (52.2%) patients presented after twenty-four hours of onset of symptoms. Most perforations were located on the first part of the duodenum (117,86%). There were 73 postoperative complications recorded in 31(22.8%) patients. Old age, being female, presence of comorbidity, hypotension, tachycardia, and delayed presentation were significantly associated with postoperative morbidity (P<0.05). Nine (6.6%) patients died at the hospital. Mortality was significantly associated with old age, comorbid illness, tachycardia, and development of post-operative complications (P<0.05). The postoperative hospital stay of the patients with complications was 18.6 ± 14.7 days which was significantly higher than that of patients without complication 6.7±2.7days (P=0.001).
Conclusion:
Old age, being female, presence of comorbidity, hypotension, tachycardia, and delayed presentation were significantly associated with postoperative morbidity. Old age, comorbid illness, tachycardia and development of post-operative complications were found to increase the risk of mortality.
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