Perforated peptic ulcer in southeastern Taiwan

• Published in: Journal of gastroenterology and hepatology Vol. 25; no. 9; pp. 1530 - 1536
• Main Authors: Li, Chin-Hsien, Chang, Wen-Hsiung, Shih, Shou-Chuan, Lin, Shee-Chan, Bair, Ming-Jong
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.09.2010; Wiley-Blackwell
• Subjects: aborigines; Adult; Age Factors; Aged; Aged, 80 and over; Alcohol Drinking - ethnology; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Areca - adverse effects; Asian Continental Ancestry Group - statistics & numerical data; Biological and medical sciences; Biomarkers - blood; Chi-Square Distribution; Comorbidity; Creatinine - blood; Digestive System Surgical Procedures - adverse effects; Digestive System Surgical Procedures - mortality; Duodenal Ulcer - ethnology; Duodenal Ulcer - mortality; Duodenal Ulcer - surgery; Female; Gastrectomy - adverse effects; Gastroenterology. Liver. Pancreas. Abdomen; Hemoglobins - analysis; Humans; Lipase - blood; Logistic Models; Male; Mastication - ethnology; Medical sciences; Middle Aged; morbidity; mortality; Other diseases. Semiology; Peptic Ulcer Perforation - ethnology; Peptic Ulcer Perforation - mortality; Peptic Ulcer Perforation - surgery; perforated peptic ulcer; Preoperative Period; Retrospective Studies; Risk Assessment; Risk Factors; Sex Factors; Shock - ethnology; Shock - mortality; Stomach Ulcer - ethnology; Stomach Ulcer - mortality; Stomach Ulcer - surgery; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Taiwan - epidemiology; Treatment Outcome; Vagotomy - adverse effects; Asia; Taiwan; Gastroduodenal; Prognosis; Mortality; Gastroenterology; perforated peptic ulcer; Peptic ulcer; Digestive diseases; Intestinal disease; Epidemiology; aborigines; Morbidity; Gastric disease
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2010.06348.x

Background:  No studies focus on the population with perforated peptic ulcer in southeastern Taiwan. The present study aimed to assess the differences between the different races and the risk factors related to mortality and morbidity in postoperative patients in southeastern Taiwan. Methods:  The medical records of 237 patients were reviewed retrospectively. The following factors were analyzed: patient profiles, coexisting illnesses, diagnostic method, fever, preoperative shock, clinical data at emergency room, delay operation, site of perforation, operative method, positive ascites culture, species of microbes in ascites culture, postoperative complications, death and the length of hospital stay. Results:  Aborigines were significantly different from non‐aborigines in the ratio of female cases and in the habits of alcohol drinking and betel nut chewing. There were also four significantly different variables between them: fever, hemoglobin value, site of perforation and operative method. Total postoperative complication rate was 41.3% and 39 patients (16.6%) died. In multivariate analysis, age ≧ 65 years, lipase > upper normal limit and preoperative shock were independent predictors of mortality. Significant risk factors associated with morbidity were NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock. Conclusion:  Aborigines were different from non‐aborigines in several categories. In southeastern Taiwan, NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock were independent risk factors of morbidity, and age ≧ 65 years, lipase > upper normal limit and preoperative shock were independent risk factors of mortality in postoperative perforated peptic ulcer. Lipase > upper normal limit is needed for further research on the influence on mortality.