Testini M, Portincasa P, Piccinni G, Lissidini G, Pellegrini F, Greco L. Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer. World J Gastroenterol 2003; 9(10): 2338-2340 [PMID: 14562406 DOI: 10.3748/wjg.v9.i10.2338]
Corresponding Author of This Article
Mario Testini, MD, Sezione Chirurgia Generale, Vascolare ed Oncologia Clinica, Dipartimento per le Applicazioni in Chirurgia delle Tecnologie Innovative (D.A.C.T.I.). Università degli Studi di Bari. mario.testini@tin.it
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World J Gastroenterol. Oct 15, 2003; 9(10): 2338-2340 Published online Oct 15, 2003. doi: 10.3748/wjg.v9.i10.2338
Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer
Mario Testini, Piero Portincasa, Giuseppe Piccinni, Germana Lissidini, Fabio Pellegrini, Luigi Greco
Mario Testini, Giuseppe Piccinni, Germana Lissidini, Section of General Surgery and Vascular Surgery and Clinical Oncology, Department of Applications in Surgery of Innovative Technologies (DACTI), University Medical School, Bari, Italy
Piero Portincasa, Section of Internal Medicine, Department of Internal Medicine and Public Medicine (DIMIMP), University Medical School, Bari, Italy
Fabio Pellegrini, Department of Clinical Pharmacology and Epidemiology, Pharmacological Research Institute, Consortium “Mario Negri” South, Maria Imbaro (L’Aquila), Italy
Luigi Greco, Section of General Surgery, Department of Emergency and Organ Transplantations (DETO), University Medical School, Bari, Italy This paper is dedicated to the memory of Prof. Francesco Paccione, Head of the Department of Surgery who died prematurely in 1996.
Author contributions: All authors contributed equally to the work.
Correspondence to: Mario Testini, MD, Sezione Chirurgia Generale, Vascolare ed Oncologia Clinica, Dipartimento per le Applicazioni in Chirurgia delle Tecnologie Innovative (D.A.C.T.I.). Università degli Studi di Bari. mario.testini@tin.it
Telephone: +39-80-5592882 Fax: +39-80-5478759
Received: May 13, 2003 Revised: July 25, 2003 Accepted: August 2, 2003 Published online: October 15, 2003
Abstract
AIM: To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city.
METHODS: One hundred and forty-nine consecutive patients (M:F ratio = 110:39, mean age 52 yrs, range 16-95) with peptic ulcer disease were investigated for clinical history (including age, sex, previous history of peptic ulcer, associated diseases, delayed abdominal surgery, ulcer site, operation type, shock on admission, postoperative general complications, and intra-abdominal and/or wound infections), serum analyses and radiological findings.
RESULTS: The overall mortality rate was 4.0%. Among all factors, an age above 65 years, one or more associated diseases, delayed abdominal surgery, shock on admission, postoperative abdominal complications and/or wound infections, were significantly associated (χ2) with increased mortality in patients undergoing surgery (0.0001 < P < 0.03).
CONCLUSION: Factors such as concomitant diseases, shock on admission, delayed surgery, and postoperative abdominal and wound infections are significantly associated with fatal outcomes and need careful evaluation within the general workup of patients admitted for perforated peptic ulcer.
