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. 1989 Apr;209(4):418–423. doi: 10.1097/00000658-198904000-00005

A multifactorial analysis of factors related to lethality after treatment of perforated gastroduodenal ulcer. 1935-1985.

C Svanes 1, H Salvesen 1, B Espehaug 1, O Søreide 1, K Svanes 1
PMCID: PMC1493985  PMID: 2930287

Abstract

One thousand one hundred and twenty-eight patients treated for perforated gastroduodenal ulcer during the years 1935-1985 were studied at the Haukeland University Hospital. The majority of patients (97.7%) were treated surgically. The data was analyzed by contingency tables and chi square testing, and a stepwise logistic regression analysis was performed in order to reveal interactions between variables and to elucidate time trends in lethality rates. The total postperforation lethality was 7.4%, the postsurgical death rate was 6.6%, and the death rate among conservatively treated patients was 42.3%. Lethality was significantly influenced by year of hospital admission and increased markedly with the age of the patients. For all age groups, the lethality decreased markedly with time. Treatment delay was associated with a moderate but significant increase in lethality. In patients with gastric ulcer the lethality was 3.6 times higher than in those with duodenal ulcer. The death rate was similar in the duodenal and pyloric ulcer groups. Death rate decreased with time in both stomach ulcer, duodenal, and pyloric ulcer patients. There was no sex difference and no difference between patients treated with simple suture or gastric resection.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ANTILA L. E. PERFORATED PEPTIC ULCER WITH GENERALISED PERITONITIS. EARLY AND LATE PROGNOSIS IN 413 CASES. Acta Chir Scand. 1964 Oct;128:406–413. [PubMed] [Google Scholar]
  2. Boey J., Wong J., Ong G. B. A prospective study of operative risk factors in perforated duodenal ulcers. Ann Surg. 1982 Mar;195(3):265–269. doi: 10.1097/00000658-198203000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Boey J., Wong J. Perforated duodenal ulcers. World J Surg. 1987 Jun;11(3):319–324. doi: 10.1007/BF01658109. [DOI] [PubMed] [Google Scholar]
  4. Cohen M. M. Treatment and mortality of perforated peptic ulcer: a survey of 852 cases. Can Med Assoc J. 1971 Aug 7;105(3):263–passim. [PMC free article] [PubMed] [Google Scholar]
  5. Donaldson G. A., Jarrett F. Perforated gastroduodenal ulcer disease at the Massachusetts General Hospital from 1952 to 1970. Am J Surg. 1970 Sep;120(3):306–311. [PubMed] [Google Scholar]
  6. GALL W. J., TALBOT C. H. PERFORATED GASTRIC ULCER. Br J Surg. 1964 Jul;51:500–503. doi: 10.1002/bjs.1800510708. [DOI] [PubMed] [Google Scholar]
  7. Graves A. M. Perforated Peptic Ulcer in German Clinics: An Analysis of 4,402 Cases. Ann Surg. 1933 Aug;98(2):197–209. doi: 10.1097/00000658-193308000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. HASTINGS N., MACHIDA R. Perforated peptic ulcer: results after simple surgical closure. Am J Surg. 1961 Aug;102:136–142. doi: 10.1016/0002-9610(61)90377-4. [DOI] [PubMed] [Google Scholar]
  9. Heuman R., Larsson J., Norrby S. Perforated duodenal ulcer--long-term results following simple closure. Acta Chir Scand. 1983;149(1):77–81. [PubMed] [Google Scholar]
  10. Jordan G. L., Jr, DeBakey M. E., Duncan J. M., Jr Surgical management of perforated peptic ulcer. Ann Surg. 1974 May;179(5):628–633. doi: 10.1097/00000658-197405000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kay P. H., Moore K. T., Clark R. G. The treatment of perforated duodenal ulcer. Br J Surg. 1978 Nov;65(11):801–803. doi: 10.1002/bjs.1800651111. [DOI] [PubMed] [Google Scholar]
  12. Mattingly S. S., Ram M. D., Griffen W. O., Jr Factors influencing morbidity and mortality in perforated duodenal ulcer. Am Surg. 1980 Feb;46(2):61–66. [PubMed] [Google Scholar]
  13. Maull K. I., Reath D. B. Pneumogastrography in the diagnosis of perforated peptic ulcer. Am J Surg. 1984 Sep;148(3):340–345. doi: 10.1016/0002-9610(84)90467-7. [DOI] [PubMed] [Google Scholar]
  14. McGee G. S., Sawyers J. L. Perforated gastric ulcers. A plea for management by primary gastric resection. Arch Surg. 1987 May;122(5):555–561. doi: 10.1001/archsurg.1987.01400170061009. [DOI] [PubMed] [Google Scholar]
  15. NOORDIJK J. A. Perforated peptic ulcer: the results of treatment in the Netherlands, 1934-1950; an analysis of 2551 cases. Arch Chir Neerl. 1953;5(4):262–270. [PubMed] [Google Scholar]
  16. Olsen R. K., Liavåg I., Roland M. Ulcus perforatum. Tidsskr Nor Laegeforen. 1983 Oct 10;103(28):1924–1927. [PubMed] [Google Scholar]
  17. Watkins R. M., Dennison A. R., Collin J. What has happened to perforated peptic ulcer? Br J Surg. 1984 Oct;71(10):774–776. doi: 10.1002/bjs.1800711012. [DOI] [PubMed] [Google Scholar]

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