FACTORS ASSOCIATED OF COMPLICATION AND MORTALITY IN PATIENTS WITH PERFORATED PEPTIC ULCER AT SAINT PAULHOSPITAL MILLENNIUMMEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA

Abstract

Abstract Background Peptic ulcer perforation is serious complication of peptic ulcer disease with significant morbidity and mortality. Objective toidentify factors associated for operative complication and mortality in patients operated for perforated peptic ulcer (PPU) atSaint Paul hospital millennium medical college. Methodology:A retrospective analysiswas used to conduct the study by revising a five years patient card registry data from January 2013 to December 2017 at SPHMMC and data was collected using data abstracting checklist. Basic descriptive analysis was used for describing the study population in relation to relevant variables.Qui square was used to assess the association between dependent and independent variables. Result A total of 136 patients were studied. Males outnumbered females by a ratio of 5.5: 1. The mean age of patients was 36.05 ± 16.56 years. The median duration of illness was 1.75 days. Most perforations were located on the first part of duodenum (117, 86%). The majority of patients, 126 (92.6%) had Graham’s omental patch of the perforations. There were sixty six post-operative complications recorded in thirty one (22.8%) patients. Superficial surgical site infection (30.3%) wound dehiscence (15.15%), respiratory infections (24.24%),post-operative collections (18.18%),acute kidney injury (10.6%) repair site failure (3.7%) and ECF (2.2%)were the complications recorded. Post-operative complication was significantly associated with female gender, age more than 45 years, comorbidity, SBP<90mmHg and presentations after 24hrs (P<0.05). A total of 9 patients (6.6%) died at the hospital postoperatively. Mortality was significantly associated with age more than 45 years, comorbid illness and hypotension (P<0.05). Conclusion Among the analyzed parameters female gender, old age, comorbidity, delayed presentation, and shock having comorbid disease were found to have an effect on morbidity. But only comorbid illness and hypotension were associated with mortality. Key words peptic ulcer, perforation, morbidity, mortality