Abstract
Background: Perforated peptic ulcer disease is one of the emergency surgical conditions of peptic ulcer complications with high mortality and morbidity. Although this emergency condition is prevalent in the study areas it is the first study that showed its magnitude and management outcome.
Objective: The purpose of this study was to determine the outcome and factors associated with perforated peptic ulcer disease.
Methodology: A cross-sectional study design was used. Data were analyzed using SPSS version 25 and binary logistic regression was used to see factors associated with outcomes. P value ≤0.05 was considered significant.
Result: A total of 95 patients were studied. Males outnumbered females by a ratio of 8.5:1. The mean and median age of patients was 31.74±13.83 and 27 years respectively. Most perforations were located on the first part of the duodenum (78, 76.5%). Most patients (90, 88.2%) had Graham’s omental patch repair. There were fifty-six post-operative complications recorded in 20 (21.1%) patients. Superficial surgical site infection (10.5%), wound dehiscence (9.5%), respiratory infections (20.1%), sepsis (17.9%), acute kidney injury (12.6%), and ECF (1.1%) were the complications recorded. Co-morbidity [AOR: 19.46 (2.39-158.39)] and SBP<90mmHg [AOR: 5.76 (1.74-19.18)] were significantly associated with post-operative complications. The mortality rate was 5.3% (95% CI: 1.7% to 11.9%) and only co-morbidity [AOR: 10.85 (7.64, 15.40)] was stastically associated with mortality.
Conclusion: The mortality rate of this study was low as compared with the majority of studies done the country and the region.
Publisher
Uniscience Publishers LLC
Reference37 articles.
1. Chung KT, Shelat VG. Perforated peptic ulcer-an update. World journal of gastrointestinal surgery. 2017;9(1):1. DOI: 10.4240/wjgs.v9.i1.1. PMCID: PMC5237817. PMID: 28138363.
2. Ngerageza JG. Factors associated with peptic gastroduodenal ulcer perforations in adult patients at Muhimbili National Hospital: Muhimbili University of Health and Allied Sciences; 2011.
3. Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, et al. Perforated peptic ulcer. The Lancet. 2015;386(10000):1288-98. DOI: 10.1016/S0140-6736(15)00276-7.
4. Taş İ, Ülger BV, Önder A, Kapan M, Bozdağ Z. Risk factors influencing morbidity and mortality in perforated peptic ulcer disease. Turkish Journal of Surgery/Ulusal cerrahi dergisi. 2015;31(1):20. DOI: 10.5152/UCD.2014.2705.
5. Hooi JK, Lai WY, Ng WK, Suen MM, Underwood FE, Tanyingoh D, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153(2):420-9. DOI: 10.1053/j.gastro.2017.04.022.