Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study.

Autor: Abouelazayem M; Department of Surgery, University College London Hospitals, London, UK. m.abouelazayem@nhs.net.; Department of Surgery, National Cancer Institute, Cairo University, Cairo, Egypt. m.abouelazayem@nhs.net.; General Surgery, University College Hospital, UCLH Contact Centre, Ground Floor North, 250 Euston Road, London, NW1 2PG, UK. m.abouelazayem@nhs.net., Jain R; Shrewsbury & Telford Hospital NHS Trust, Shrewsbury, UK., Wilson MSJ; Department of General Surgery, Forth Valley Royal Hospital, Larbert, UK., Martinino A; Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA., Balasubaramaniam V; Ysbyty Gwynedd Hospital, Bangor, Wales, UK., Biffl W; Trauma and Acute Care Surgery, Scripps Memorial Hospital, La Jolla, San Diego, CA, USA., Coccolini F; General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy., Riera M; Royal Shrewsbury Hospital, Shrewsbury, UK., Wadhawan H; Department of General Surgery, Forth Valley Royal Hospital, Larbert, UK., Wazir I; VMMC & Safdarjung Hospital, New Delhi, India., Abderaouf B; Public Hospital Establishment Mohamed Sayah of SOBHA, Algeria, Algeria., Abramov D; Immanuel Kant Baltic Federal University, Kaliningrad, Russia., Abu Jayyab MA; Nasser Medical Complex, Gaza, Palestine., Al-Shami K; Al-Basheer Hospital, Amman, Jordan., Alfarwan A; Damascus University, Damascus, Syria., Alhajami FM; United Hospital, 21 September University, Yemen, Yemen., Alkaseek A; Gharyan Central Hospital, Garian, Libya., Alozairi O; Aladan Hospital, Hadiya, Kuwait., Ammar AS; MAYO Hospital, Lahore, Pakistan., Atar B; Bakırköy Training and Research Hostpital, Bakirkoy, Turkey., Baatarjav GE; The Second State Central Hospital, Ulaanbaatar, Mongolia., Bains L; Maulana Azad Medical College, New Delhi, India., Bakri A; Tishreen University Hospital, Latakia, Syria., Bayramov N; Azerbaijan Medical University, Baku, Azerbaijan., Bhojwani R; Santokba Durlabhji Memorial Hospital (SDMH), Jaipur, India., Brachini G; Policlinico Umberto I, Sapienza University of Rome, Rome, Italy., Calini G; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy., Campanelli M; San Carlo of Nancy Hospital, University of Rome Tor Vergata, Rome, Italy., Cheng SY; Penang General Hospital, George Town, Malaysia., Choudhary CS; SMS Hospital, Jaipur, India., Chowdhury S; King Saud Medical City, Riyadh, Saudi Arabia., Colak E; University of Samsun, Samsun, Turkey., Das JK; Nazareth Hospital, Shillong, India., Dawani S; Jinnah Postgraduate and Medical Center, Karachi, Pakistan., Dönmez T; Bakırköy Training and Research Hospital, Bakirkoy, Turkey., Elzayat I; Faculty of Medicine, Aswan University, Aswan, Egypt., Erdene S; Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia., Faizi TQ; Jinnah Postgraduate and Medical Center, Karachi, Pakistan., Frountzas M; First Propaedeutic Department of Surgery, Hippocration General Hospital of Athens, Athens, Greece., Gafsi B; Fattouma Bourguiba University Hospital, Monastir, Tunisia., Gentileschi P; San Carlo of Nancy Hospital, University of Rome Tor Vergata, Rome, Italy., Guler M; Istanbul Research and Training Hospital, Istanbul, Turkey., Gupta G; SMS Hospital, Jaipur, India., Harkati NE; University Hospital Center-Benflis Touhami-Batna, Batna, Algeria., Harris M; Royal Liverpool and Broadgreen NHS Trust, Liverpool, UK., Hasan DM; Imbaba General Hospital, Giza, Egypt., Irowa OO; University of Benin Teaching Hospital, Benin City, Nigeria., Jafferi S; Jinnah Postgraduate and Medical Center, Karachi, Pakistan., Jain SA; SMS Hospital, Jaipur, India., Jun Han L; Hospital Melaka, Melaka, Malaysia., Kandiboyina SM; NRI Medical College, General & Superspeciality Hospital, Chinakakani, India., Karabulut M; Bakırköy Training and Research Hostpital, Bakirkoy, Turkey., Khamees A; Al-Basheer Hospital, Amman, Jordan., Khan S; MTI Khyber Teaching Hospital, Peshawar, Pakistan., Khan MM; Jinnah Postgraduate and Medical Center, Karachi, Pakistan., Khaw CJ; Penang General Hospital, George Town, Malaysia., Kisielewski M; Akademia Frycza-Modrzewskiego, Kraków, Poland., Klib M; Damascus University, Damascus, Syria., Košir JA; UMC Ljubljana, Ljubljana, Slovenia., Krawczyk WJ; Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Katowice, Poland., Lisi G; Department of Surgery, Sant'Eugenio Hospital, Viale Dell'Umanesimo 10, Rome, Italy., Makama JG; Department of Surgery, Barau Dikko Teaching Hospital-KASU, Kaduna, Nigeria., Maqbool B; University of New Mexico, Albuquerque, USA., Marques CN; Centro Hospitalar Universitario, Lisbon Central, Lisbon, Portugal., Meric S; Bagcilar Training and Research Hospital, Istanbul, Turkey., Mietła MP; Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Katowice, Poland., Ads AM; Tanta University Hospital, Tanta, Egypt., Muhumuza J; Kampala International University, Kampala, Uganda., Mulita F; General University Hospital of Patras, Rio, Greece., Mustafayeva M; Scientific Center of Surgery After Named M.A.Topchubashov, Azerbaijan, Azerbaijan., Omar MA; General Surgery Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt., Omarov T; Azerbaijan Medical University, Baku, Azerbaijan., Pathak AA; GTB Hospital, New Delhi, Delhi, India., Paul R; Silchar Medical College, Silchar, India., Pavone G; University of Foggia, Foggia, Italy., Podda M; Department of Emergency Surgery, Cagliari University Hospital, Cagliari, Italy., Raja Ram NK; Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Rauf F; Benazir Bhutto Hospital, Rawalpindi, Pakistan., Rauf S; Pakistan Institute of Medical Sciences, Islamabad, Pakistan., Safy AM; General Surgery Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt., Sandag E; Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia., Şanlı AN; Abdulkadir Yüksel State Hospital, Gaziantep, Turkey., Siddiqui AZ; Jinnah Postgraduate and Medical Center, Karachi, Pakistan., Sotiropoulou M; Evagelismos Hospital, Athens, Greece., Talib V; Jinnah Postgraduate and Medical Center, Karachi, Pakistan., Tatar C; Istanbul Research and Training Hospital, Istanbul, Turkey., Thota A; NRI Medical College, General & Superspeciality Hospital, Chinakakani, India., Tokocin M; Bagcilar Training and Research Hospital, Istanbul, Turkey., Tolat A; VMMC & Safdarjung Hospital, New Delhi, India., Uchikov PA; Univesity Hospital St. George, Plovdiv, Bulgaria., Valenzuela JI; Hospital Velez Sarsfield, Ciudadela, Argentina., Venkatappa SK; Victoria Hospital, Bangalore Medical College & Research Institute, Bengaluru, India., Verras GI; General University Hospital of Patras, Rio, Greece., Vlahović I; Department of Surgery, Clinical Hospital Center Osijek, University of Osijek, Osijek, Croatia., Zreeg DAS; Alkhadra Hospital, Tripoli, Libya., Cardoso VR; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.; Centre for Health Data Science, University of Birmingham, Birmingham, UK., Gkoutos GV; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.; Centre for Health Data Science, University of Birmingham, Birmingham, UK., Singhal R; University Hospital Birmingham NHS Foundation Trust, Birmingham, UK., Mahawar K; South Tyneside and Sunderland NHS Foundation Trust, University of Sunderland, Sunderland, UK.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Aug; Vol. 38 (8), pp. 4402-4414. Date of Electronic Publication: 2024 Jun 17.
DOI: 10.1007/s00464-024-10881-0
Abstrakt: Background: There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these.
Method: We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality.
Results:  1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4-2), (OR = 4.7, 95% CI 3.1-7.6)], female gender [(OR = 1.8, 95% CI 1.4-2.3), (OR = 1.9, 95% CI 1.3-2.9)], shock on admission [(OR = 2.1, 95% CI 1.7-2.7), (OR = 4.8, 95% CI 3.2-7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9-3.2), (OR = 3.9), 95% CI 2.7-5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1-1.6], but not mortality.
Conclusions: This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality.
(© 2024. Crown.)
Databáze: MEDLINE
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