Low serum albumin may predict poor efficacy in patients with perforated peptic ulcer treated nonoperatively

Table 1 Comparison of baseline patient characteristics between the two groups, n (%)

Variables	Surgical group	NOM group	P value
	n = 50	n = 222
Age in yr, average (median)	66.5 (15.8)	58.0 (21.3)	< 0.001
≥ 70 yr	19 (38.0)	44 (19.8)	0.006
Male, n (%)	32 (64.0)	162 (73.0)	0.205
Hypertension	16 (32.0)	45 (20.3)	0.072
DM	11 (22.0)	28 (12.6)	0.087
Smoking	26 (52.0)	83 (37.4)	0.057
Alcohol consumption	18 (36.0)	56 (25.2)	0.122
NSAIDs use	16 (32.0)	50 (22.5)	0.158
Pain duration prior to admission (median)	8.0 (9.0)	6.0 (6.0)	0.001
≥ 12 h	16 (32.0)	33 (14.9)	0.004
Heart rate (bpm) (median)	92.0 (24.0)	86.0 (18.0)	0.116
Body temperature (C) (median)	36.7 (1.2)	36.7 (0.7)	0.826
≥ 38 C	9 (18.0)	19 (8.6)	0.047
Hemoglobin (g/L)	116.8 22.7	126.5 22.2	0.006
< 90 g/L	7 (14.0)	15 (6.8)	0.090
WBC count (× 109/L) (median)	9.5 (6.6)	10.5 (3.3)	0.479
≥ 12 × 109/L	18 (36.0)	77 (34.7)	0.860
Procalcitonin (ng/mL) (median)	5.14 (10.03)	0.88 (3.96)	< 0.001
CRP (mg/L) (median)	151.28 (151.16)	68.46 (119.35)	< 0.001
Serum albumin (g/L)	27.5 4.65	33.7 6.79	< 0.001
< 30 g/L	32 (64.0)	54 (24.3)	< 0.001

CRP: C-reactive protein; DM: Diabetes mellitus; NOM: Nonoperative management; NSAIDs: Non-steroidal anti-inflammatory drugs; WBC: White blood cell.

Table 2 Adverse outcomes of patients with perforated peptic ulcer, n (%)

Complications	Surgical group, n = 50	NOM group, n = 222	P value
Wound infection	3 (6.0)	0	0.006
Respiratory infection	2 (4.0)	11 (5.0)	1.000
Urinary infection	4 (8.0)	9 (4.1)	0.415
Ascites	3 (6.0)	24 (10.8)	0.304
Pleural effusion	3 (6.0)	7 (3.2)	0.582
Abdominal abscess	0 (0)	5 (2.3)	0.588
Total complications	15 (30)	56 (25.2)	0.487
Length of hospital stay in d	12 (7)	9 (3)	< 0.001

NOM: Nonoperative management.

Table 3 Logistic regression analysis for determining the independent predictors of poor efficacy of nonoperative management in patients with perforated peptic ulcer

Variable	OR	95%CI	P value	Adjusted OR	95%CI	P value
Age ≥ 70 yr	2.479	1.282-4.795	0.007	1.278	0.605-2.698	0.521
Male	0.658	0.344-1.260	0.207
Hypertension	1.851	0.939-3.648	0.075
Diabetes mellitus	1.954	0.898-4.253	0.091
Smoking status	1.814	0.978-3.365	0.059
Alcohol consumption	1.667	0.869-3.201	0.124
NSAIDs use	1.619	0.826-3.171	0.160
Pain duration prior to admission ≥ 12 h	2.695	1.339-5.427	0.005	2.495	1.163-5.352	0.019
Heart rate	1.018	0.998-1.037	0.071
Body temperature ≥ 38 C	2.345	0.991-5.549	0.052
Hemoglobin < 90 g/L	0.445	0.171-1.157	0.097
WBC count ≥ 12 × 109/L	1.059	0.058-2.009	0.860
Procalcitonin	1.027	1.000-1.056	0.052
CRP	1.001	1.000-1.002	0.198
Serum albumin < 30 g/L	5.331	2.876-10.635	< 0.001	5.073	2.527-10.184	< 0.001

CRP: C-reactive protein; NSAIDs: Non-steroidal anti-inflammatory drugs; PPU: Perforated peptic ulcer; WBC: White blood cell.

Table 4 Logistic regression analysis of predictors of clinical complications in patients with perforated peptic ulcer

Variables	OR	95%CI	P value	Adjusted OR	95%CI	P value
Age ≥ 70 yr	2.331	1.277-4.254	0.006	1.630	0.853-3.114	0.139
Male	1.390	0.777-2.488	0.268
Hypertension	1.008	0.528-1.928	0.980
Diabetes mellitus	1.729	0.842-3.550	0.136
Smoking status	0.757	0.432-1.328	0.331
Alcohol consumption	0.970	0.527-1.785	0.922
NSAIDs use	0.977	0.519-1.839	0.941
Pain duration prior to admission ≥ 12 h	1.316	0.667-2.594	0.428
Heart rate	1.005	0.988-1.023	0.568
Body temperature ≥ 38 C	0.586	0.214-1.606	0.299
Hemoglobin < 90 g/L	0.590	0.236-1.471	0.257
WBC count ≥ 12 × 109/L	0.787	0.441-1.405	0.418
Procalcitonin	1.021	0.994-1.048	0.126
CRP	1.000	0.999-1.001	0.933
Serum albumin < 30 g/L	3.376	1.917-5.946	< 0.001	2.945	1.625-5.339	< 0.001

CRP: C-reactive protein; NSAIDs: Non-steroidal anti-inflammatory drugs; PPU: Perforated peptic ulcer; WBC: White blood cell.