Surgical Mortality and Morbidity Predictors in Patients With Perforated Peptic Ulcer: A Cohort Study

Introduction: Perforated peptic ulcer (PPU) is a common surgical emergency worldwide, associated with significant morbidity and mortality, if not promptly diagnosed and managed. This study aims to investigate the frequency and risk factors of mortality and morbidity in patients undergoing PPU surgery. Methods: In this cohort study, records of 102 patients, who underwent surgery for PPU between September 2020 and April 2023, were reviewed. All mortality and complications that occurred during the 6-mo period postoperatively were considered in the study. Then influencing factors were compared between groups with and without complications, and between deceased and alive. Results: Among the 102 patients with an average age of 47.56 f 17.36 y, 87.3% were male. Postoperative mortality and morbidity were 18.6% and 31.4%, respectively. Multivariant analysis showed that factors significantly associated with complications were age over 60, decreased albumin, elevated creatinine and blood urea nitrogen, comorbidities, preoperative shock, increased respiratory rate, decreased level of consciousness and contamination (P < 0.05). Moreover, elevated blood urea nitrogen, comorbidities, decreased level of consciousness and contamination were significantly associated with mortality (P < 0.05). Conclusions: Clinical assessment, timely intervention, and managing comorbidities could mitigate the mortality and morbidity risks associated with PPU surgery. The knowledge of mentioned risk factors would enable surgeons to prevent postoperative complications in patients with PPU. (c) 2025 Published by Elsevier Inc.