Duration of survival after peptic ulcer perforation.

Background: The long-term course after peptic ulcer perforation is unclear, but because the ulcer population is generally older and has concomitant disease, the long-term prognosis may be expected to be poor.

Methods: In a study based on prospective data collection, all patients with peptic ulcer perforation treated at the Department of Surgery at the Heinrich-Heine-University in Dusseldorf, Germany, were documented between 1986 and 1995. In a follow-up study, the following parameters were investigated and survival rates were estimated: hospital mortality, 1-month mortality, 1-year mortality, and 5-year mortality. Significant prognostic parameters for death were worked out in univariate and multivariate analysis.

Results: Ninety-nine out of 108 patients with peptic ulcer perforation could be followed-up. One-month mortality was similar to hospital mortality, at 9.1%; 1-year mortality was about 20.2%; and 5-year mortality was 32.3%. Statistically significant prognostic factors for death in univariate analysis were age beyond 70 years, concomitant diseases, risk-related drugs, postinterventional complications and admission status. In multivariate analysis concomitant diseases, postoperative complications, and advanced age were significant parameters for death.

Conclusions: Long-term prognosis of peptic ulcer perforation is poor. Risk factors for late mortality after peptic ulcer perforation are age, severe concomitant diseases, and postinterventional complications.