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SURVIVAL FOLLOWING PERFORATION OF PEPTIC ULCER
Author(s) -
Eenglund R.,
Fisher R.
Publication year - 1990
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1990.tb07476.x
Subject(s) - medicine , perforation , peptic ulcer , surgery , gastroenterology , peptic , mortality rate , disease , materials science , punching , metallurgy
Between 1979 and 1989, 92 patient were treated at St Geroge Hospital, Kogarah, for perforated duodenal or perpyloric ulcer. Mortality rate at 28 days was 18%. Life table analysis showed 1‐, 5‐ and 10‐year survival rates for his group to be 78%, 60% and 46% respectively. During the second half of the study period, increasingly older females with a history of cardiovascualr disease, arthropathy, chronic renal impairment and non‐sterioid anti‐inflammatory drugs (NSAIDS) intake were identified and found to be at greate risk of dying from their perforation. Age, cardiovascular disease and chronic renal impairment were demonstrated to be independent factors affecting survival. Patients treated by simple closure of the perforation had a long‐term survival rate equivalent to that of patients treated in other ways, although the number of these latter patients is small. Implications for the administration of NSAIDS are considered in the light of these findings. These results suggest that orthodox simple closure of perforated peptic ulcer and administration of H, blocking agents is the most appropriate treatment for patients presenting with perforated peptic ulcer.