Clinical characteristics of peptic ulcer perforation in Korea

World J Gastroenterol. 2017 Apr 14;23(14):2566-2574. doi: 10.3748/wjg.v23.i14.2566.

Abstract

Aim: To elucidate the epidemiological characteristics and associated risk factors of perforated peptic ulcer (PPU).

Methods: We retrospectively reviewed medical records of patients who were diagnosed with benign PPU from 2010 through 2015 at 6 Hallym university-affiliated hospitals.

Results: A total of 396 patients were identified with postoperative complication rate of 9.1% and mortality rate of 0.8%. Among 174 (43.9%) patients who were examined for Helicobacter pylori (H. pylori) infection, 78 (44.8%) patients were positive for H. pylori infection, 21 (12.1%) were on non-steroidal anti-inflammatory drugs (NSAIDs) therapy, and 80 (46%) patients were neither infected of H. pylori nor treated by any kinds of NSAIDs. Multivariate analysis indicated that older age (OR = 1.09, 95%CI: 1.04-1.16) and comorbidity (OR = 4.11, 95%CI: 1.03-16.48) were risk factors for NSAID-associated PPU compared with non-H. pylori, non-NSAID associated PPU and older age (OR = 1.04, 95%CI: 1.02-1.07) and alcohol consumption (OR = 2.08, 95%CI: 1.05-4.13) were risk factors for non-H. pylori, non-NSAID associated PPU compared with solely H. pylori positive PPU.

Conclusion: Elderly patients with comorbidities are associated with NSAIDs-associated PPU. Non-H. pylori, non-NSAID peptic ulcer is important etiology of PPU and alcohol consumption is associated risk factor.

Keywords: Duodenal ulcer; Helicobacter pylori; Non-steroidal anti-inflammatory drugs; Peptic ulcer perforation; Stomach ulcer.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Comorbidity
  • Duodenal Ulcer / diagnosis
  • Duodenal Ulcer / epidemiology*
  • Duodenal Ulcer / mortality
  • Duodenal Ulcer / surgery
  • Female
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / isolation & purification
  • Hospitals, University
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Peptic Ulcer Hemorrhage / diagnosis
  • Peptic Ulcer Hemorrhage / epidemiology*
  • Peptic Ulcer Hemorrhage / mortality
  • Peptic Ulcer Hemorrhage / surgery
  • Peptic Ulcer Perforation / diagnosis
  • Peptic Ulcer Perforation / epidemiology*
  • Peptic Ulcer Perforation / mortality
  • Peptic Ulcer Perforation / surgery
  • Postoperative Complications / epidemiology
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Stomach Ulcer / diagnosis
  • Stomach Ulcer / epidemiology*
  • Stomach Ulcer / mortality
  • Stomach Ulcer / surgery
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal