Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2021; 13(10): 1226-1234
Published online Oct 27, 2021. doi: 10.4240/wjgs.v13.i10.1226
Low serum albumin may predict poor efficacy in patients with perforated peptic ulcer treated nonoperatively
Tang-Shuai Liang, Bao-Lei Zhang, Bing-Bo Zhao, Dao-Gui Yang
Tang-Shuai Liang, Bao-Lei Zhang, Bing-Bo Zhao, Dao-Gui Yang, Department of Gastrointestinal Surgery, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Author contributions: Liang TS and Yang DG were responsible for designing the study and reviewing the manuscript; Liang TS and Zhang BL drafted the manuscript; Liang TS and Zhao BB collected the clinical data and abstracted the data; Liang TS and Zhang BL were responsible for revising the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Liaocheng People’s Hospital.
Informed consent statement: As this is a retrospective study, signed informed consent was unnecessary.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Lei Zhang, MD, Attending Doctor, Department of Gastrointestinal Surgery, Liaocheng People’s Hospital, No. 67 Dongchang West Road, Dongchangfu District, Liaocheng 252000, Shandong Province, China. wohaishilaohu@163.com
Received: March 20, 2021
Peer-review started: March 20, 2021
First decision: June 3, 2021
Revised: June 15, 2021
Accepted: August 16, 2021
Article in press: August 16, 2021
Published online: October 27, 2021
Processing time: 220 Days and 2.8 Hours
Abstract
BACKGROUND

Nonoperative management (NOM) is a promising therapeutic modality for patients with perforated peptic ulcer (PPU). However, the risk factors for poor efficacy and adverse events of NOM are a concern.

AIM

To investigate the factors predictive of poor efficacy and adverse events in patients with PPU treated by NOM.

METHODS

This retrospective case-control study enrolled 272 patients who were diagnosed with PPU and initially managed nonoperatively from January 2014 to December 2018. Of these 272 patients, 50 converted to emergency surgery due to a lack of improvement (surgical group) and 222 patients were included in the NOM group. The clinical data of these patients were collected. Baseline patient characteristics and adverse outcomes were compared between the two groups. Logistic regression analysis and receiver operating characteristic curve analyses were conducted to investigate the factors predictive of poor efficacy of NOM and adverse outcomes in patients with PPU.

RESULTS

Adverse outcomes were observed in 71 patients (32.0%). Multivariate analyses revealed that low serum albumin level was an independent predictor for poor efficacy of NOM and adverse outcomes in patients with PPU.

CONCLUSION

Low serum albumin level may be used as an indicator to help predict the poor efficacy of NOM and adverse outcomes, and can be used for risk stratification in patients with PPU.

Keywords: Perforated peptic ulcer; Peptic ulcer disease; Nonoperative treatment; Risk factor

Core Tip: Risk factors are associated with a poor efficacy in patients with perforated peptic ulcer (PPU) treated by nonoperative management (NOM), and can be used for risk stratification in patients with PPU. Serum albumin level is an important predictor of the poor efficacy of NOM.