Introduction. Surgical treatment of perforated peptic ulcer (PPU) is a challenge for surgeons in Africa.Aim. To determine risk factors of postoperative complications or mortality among black Ivoirian patients with PPU.Methods. All 161 patients (median age = 34 years, 90.7 male) operated on for PPU in the visceral and general surgery unit were enrolled in a retrospective cohort study. Variables were studied with Kaplan Meier and Cox proportional hazard models.Results. Among 161 patients operated on for PPU, 36 (27.5%) experienced complications and 31 (19.3%) died. Follow-up results were the incidence of complications and mortality of 6.4 (95% CI: 4.9–8.0) per 100 person-days and 3.0 (95% CI: 1.9–4.0) per 100 person-days for incidence of mortality. In multivariate analysis, risk factors of postoperative complications or mortality were comorbidities (HR = 2.1,P=0.03), tachycardia (pulse rate > 100/minutes) (HR = 2.4,P=0.02), purulent intra-abdominal fluid collection (HR = 2.1,P=0.04), hyponatremia (median value ≤ 134 mEq/L) (HR = 2.3,P=0.01), delayed time of hospital admission > 72 hours (HR = 2.6,P<0.0001), and delayed time of surgical intervention between 24 and 48 hours (HR = 3.8,P<0.0001).Conclusion. The delayed hospital admission or surgical intervention and hyponatremia may be considered as additional risk of postoperative complications or mortality in Black African patients with PPU.
Five year experience in management of perforated peptic ulcer and validation of common mortality risk prediction models – Are existing models sufficient? A retrospective cohort study
