Ahmad Din Waqas, Shaukat Hussain, Muhammad Shah, Yousaf Jan.
Accuracy of prognostic factors in detecting one month mortality for perforated peptic ulcer disease.
Pak J Surg Jan ;31(4):232-7.

Background: Perforated peptic ulcer is a serious condition with an overall reported mortality of 5%–25%, rising to as high as 50% with age. Being closely related to advanced age, increased burden of co morbidity may partially explain the higher mortality among elderly patients. Objective: To determine the accuracy of prognostic factors in detecting one month mortality aft er surgery for perforated peptic ulcer disease. Material and methods: Th is study was conducted aft er approval from hospitals ethical and research committ ee. All the patients presenting with perforated peptic ulcer disease and prognostic factors (mentioned below) were included in the study through OPD/ER department and immediately admitt ed in the surgical ward for further evaluation. Th e standard guidelines for surgery were followed for all patients including perforation closure with Graham’s patch omentoplasty. All patients were kept in ward for 5 post operative days and discharged on 6th post operative day if indicated. All patients were regularly followed till one month aft er surgery to detect accuracy of the prognostic factors in terms of 30 day mortality. Results: In this study, 167 patients with perforated peptic ulcer disease had observed. Male to female ratio was 1.49:1. Th e study included age ranged from 19 up to 72 years. Average age was 40.89 years + 15.3SD. Accuracy of prognostic factors to detect in hospital mortality in the peptic ulcer disease was 118(70.66%). Conclusion: Age, delayed surgery, presence of shock, ASA risk and defi nitive surgery are factors signifi cantly associated with fatal outcomes in patients undergoing emergency surgery for perforated PU. Th erefore, proper resuscitation from shock, improving ASA grade, decreasing delay and reserving defi nitive surgery for selected patients is needed to improve overall results.

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