Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 7, Number 1, February 2014, pages 5-11

Prognostic Factors and Complications in Patients With Operational Peptic Ulcer Perforation in Northern Thailand

**Table 1.** Patient Characteristics of Post-Operative PUP* Outcomes
Patient characteristics	Complications (n = 87, 9.54%)	Recovered (n = 825, 90.46%)	P value
^*PUP: peptic ulcer perforation.
Gender
Male	64 (73.56)	645 (78.18)	0.325
Age (years)
Median (IQR)	78.5 (15 - 92)	66 (15 - 87)	< 0.001
Underlying illnesses
Diabetes mellitus	11 (12.64)	46 (5.58)	0.010
Hypertension	27 (31.03)	168 (20.36)	0.021
Lung disease	38 (43.68)	64 (7.76)	< 0.001
Liver disease	13 (14.94)	22 (2.67)	< 0.001
Heart disease	33 (37.93)	114 (13.82)	< 0.001
Kidney disease	20 (22.99)	57 (6.91)	< 0.001
Systolic blood pressure ≤ 90 mmHg	68 (78.16)	44 (5.33)	< 0.001
Referred from lower level hospitals	60 (68.97)	640 (77.58)	0.071
Duration of operation > 3 h	33 (37.93)	54 (6.55)	< 0.001
Prolonged ventilation > 24 h	33 (37.93)	54 (6.55)	< 0.001
Unplanned admission to ICU	70 (80.46)	630 (76.36)	0.390

Table 1. Patient Characteristics of Post-Operative PUP* Outcomes

Patient characteristics

Complications (n = 87, 9.54%)

Recovered (n = 825, 90.46%)

P value

^*PUP: peptic ulcer perforation.

Gender

Male

64 (73.56)

645 (78.18)

0.325

Age (years)

Median (IQR)

78.5 (15 - 92)

66 (15 - 87)

< 0.001

Underlying illnesses

Diabetes mellitus

11 (12.64)

46 (5.58)

0.010

Hypertension

27 (31.03)

168 (20.36)

0.021

Lung disease

38 (43.68)

64 (7.76)

< 0.001

Liver disease

13 (14.94)

22 (2.67)

< 0.001

Heart disease

33 (37.93)

114 (13.82)

< 0.001

Kidney disease

20 (22.99)

57 (6.91)

< 0.001

Systolic blood pressure ≤ 90 mmHg

68 (78.16)

44 (5.33)

< 0.001

Referred from lower level hospitals

60 (68.97)

640 (77.58)

0.071

Duration of operation > 3 h

33 (37.93)

54 (6.55)

< 0.001

Prolonged ventilation > 24 h

33 (37.93)

54 (6.55)

< 0.001

Unplanned admission to ICU

70 (80.46)

630 (76.36)

0.390

**Table 2.** Distribution of Post-Operational Complications
Post-operational complications	Number (n=912)	Percentage
Surgical site infection	32	3.51
Re-operation	11	1.21
Pneumonia	74	8.11
Death	18	1.97

Table 2. Distribution of Post-Operational Complications

Post-operational complications

Number (n=912)

Percentage

Surgical site infection

3.51

Re-operation

1.21

Pneumonia

8.11

Death

1.97

**Table 3.** Frequency, Incidence Rate Ratio (IRR) and 95% Confidence Interval of Associated Outcomes With Mortality Between PUP Patients With and Without Post-Operational Complications
Associated outcomes	Outcomes presence	Mortality	IRR (95%CI)	P value
Surgical site infection	No	8 (44.44%)	Reference	0.158
Yes	10 (55.56%)	2.00 (0.76 - 5.27)
Re-operation	No	15 (82.33%)	Reference	0.137
Yes	3 (16.67%)	2.65 (0.73 - 9.62)
Pneumonia	No	0 (0.00%)	Reference	0.958
Yes	18 (100.00%)	6.97 (6.30 - 7.70)

Table 3. Frequency, Incidence Rate Ratio (IRR) and 95% Confidence Interval of Associated Outcomes With Mortality Between PUP Patients With and Without Post-Operational Complications

Associated outcomes

Outcomes presence

Mortality

IRR (95%CI)

P value

Surgical site infection

8 (44.44%)

Reference

0.158

Yes

10 (55.56%)

2.00 (0.76 - 5.27)

Re-operation

15 (82.33%)

Reference

0.137

Yes

3 (16.67%)

2.65 (0.73 - 9.62)

Pneumonia

0 (0.00%)

Reference

0.958

Yes

18 (100.00%)

6.97 (6.30 - 7.70)

**Table 4.** Post-Operative Length of Stay (PLOS) Between PUP Patients With and Without Post-Operational Complications
Associated outcomes	PLOS (days)	P value
Surgical site infection
Median (IQR)	7 (1 - 29)	10 (7 - 31)	0.004
Re-operation
Median (IQR)	6 (1 - 22)	11 (1 - 31)	0.002
Pneumonia
Median (IQR)	6 (1 - 25)	15 (1 - 31)	< 0.001
Death
Median (IQR)	6 (1 - 31)	1 (1 - 5)	< 0.001

Table 4. Post-Operative Length of Stay (PLOS) Between PUP Patients With and Without Post-Operational Complications

Associated outcomes

PLOS (days)

P value

Without complications (n = 825)

With complications (n = 87)

Surgical site infection

Median (IQR)

7 (1 - 29)

10 (7 - 31)

0.004

Re-operation

Median (IQR)

6 (1 - 22)

11 (1 - 31)

0.002

Pneumonia

Median (IQR)

6 (1 - 25)

15 (1 - 31)

< 0.001

Death

Median (IQR)

6 (1 - 31)

1 (1 - 5)

< 0.001

**Table 5.** Risk Ratio (RR) and 95% Confidence Interval of Prognostic Factors for Post- Operative Complications
Prognostic factors	Multivariable RR	95%CI	P value
Gender
Male	0.35	0.06 - 1.96	0.235
Age (years)
≥ 60	0.11	0.013 - 0.84	0.034
Underlining illnesses
Diabetes mellitus	2.15	0.53 - 8.73	0.281
Diabetes mellitus	1.12	0.34 - 3.74	0.851
Lung disease	1.33	0.29 - 6.05	0.715
Liver disease	5.41	1.36 - 21.56	0.015
Heart disease	1.23	0.28 - 5.29	0.784
Kidney disease	4.72	1.05 - 21.11	0.042
Systolic blood pressure ≤ 90 mmHg	2.42	0.30 - 19.41	0.407
Duodenal ulcer perforation	3.52	0.31 - 40.50	0.313
Elective surgery	2.02	0.42 - 9.88	0.383
Duration of perforation > 3 h	9.83	1.61 - 59.66	0.013
Referred from lower level hospitals	0.97	0.18 - 5.10	0.969
Unplanned admission to ICU	9.22	1.55 - 54.68	0.014
Prolonged ventilation > 24 h	9.02	0.42 - 9.88	0.038

Table 5. Risk Ratio (RR) and 95% Confidence Interval of Prognostic Factors for Post- Operative Complications

Prognostic factors

Multivariable RR

95%CI

P value

Gender

Male

0.35

0.06 - 1.96

0.235

Age (years)

≥ 60

0.11

0.013 - 0.84

0.034

Underlining illnesses

Diabetes mellitus

2.15

0.53 - 8.73

0.281

Diabetes mellitus

1.12

0.34 - 3.74

0.851

Lung disease

1.33

0.29 - 6.05

0.715

Liver disease

5.41

1.36 - 21.56

0.015

Heart disease

1.23

0.28 - 5.29

0.784

Kidney disease

4.72

1.05 - 21.11

0.042

Systolic blood pressure ≤ 90 mmHg

2.42

0.30 - 19.41

0.407

Duodenal ulcer perforation

3.52

0.31 - 40.50

0.313

Elective surgery

2.02

0.42 - 9.88

0.383

Duration of perforation > 3 h

9.83

1.61 - 59.66

0.013

Referred from lower level hospitals

0.97

0.18 - 5.10

0.969

Unplanned admission to ICU

9.22

1.55 - 54.68

0.014

Prolonged ventilation > 24 h

9.02

0.42 - 9.88

0.038