RISK FACTORS AND MANNHEIM PERITONITIS INDEX FOR THE PREDICTION OF MORBIDITY AND MORTALITY IN PATIENTS WITH PEPTIC ULCER PERFORATION

Objective: In urgent surgical procedures for peptic ulcer perforation, there is considerable postoperative morbidity and mortality. This study aimed to describe and analyze the risk factors that determine beforehand morbidity and mortality in cases with perforated peptic ulcer. Material and Method: Age, sex, co-morbid diseases, symptom duration, abdominal free air, amount of intraabdominal liquid, location and diameter of perforation, type of the operation, and the Mannheim Peritonitis Index (MPI) score were prospectively analyzed in 128 cases. Significant risk factors that cause morbidity and mortality were determined through a statistical study. Results: The study sample consisted of a total of 128 cases (113 males and 15 females) with a mean age of 37 (range, 20-84). Duodenum and stomach perforations were detected in 93% and 5.5% of the cases respectively. In 12 cases (9.4%), a total of 14 complications were detected. The mortality rate was 4.7%. Statistical analyses revealed significant relationships between morbidity and >50 age (p=0.000), co-morbid disease (p=0.006), perforation location (p=0.0010), type of operation (p=0.011), and MPI score (p=0.005). The factors significant for mortality included >50 age (p=0.002), co-morbid disease (p=0.017), >8 hours of symptom duration (p=0.07), >500 cc intra-abdominal fluid (p=0.047), diameter of perforation >0.5 cm (p=0.001), omentoplasty (p=0.025), and a MPI score of >21 (p=0.000). Conclusion: Factors such as age, co-morbid disease, prolonged perforation duration, amount of intra-abdominal fluid, perforation diameter, type of surgical operation, and MPI score were significant for mortality.