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Gona, Soro Kountele; Alassan, Mahassadi Kouamé; Marcellin, Koffi Gnangoran; Henriette, Kissi Ya; Adama, Coulibaly; Toussaint, Assohoun; Manuela, Ehua Adjoba; Sylvain, Seu Gagon; Anthony, Afum-Adjei Awuah; Francis, Ehua Somian

Postoperative Morbidity and Mortality of Perforated Peptic Ulcer: Retrospective Cohort Study of Risk Factors among Black Africans in Côte d’Ivoire

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  • Media type: E-Article
  • Title: Postoperative Morbidity and Mortality of Perforated Peptic Ulcer: Retrospective Cohort Study of Risk Factors among Black Africans in Côte d’Ivoire
  • Contributor: Gona, Soro Kountele; Alassan, Mahassadi Kouamé; Marcellin, Koffi Gnangoran; Henriette, Kissi Ya; Adama, Coulibaly; Toussaint, Assohoun; Manuela, Ehua Adjoba; Sylvain, Seu Gagon; Anthony, Afum-Adjei Awuah; Francis, Ehua Somian
  • imprint: Hindawi Limited, 2016
  • Published in: Gastroenterology Research and Practice
  • Language: English
  • DOI: 10.1155/2016/2640730
  • ISSN: 1687-6121; 1687-630X
  • Keywords: Gastroenterology ; Hepatology
  • Origination:
  • Footnote:
  • Description: <jats:p><jats:italic>Introduction</jats:italic>. Surgical treatment of perforated peptic ulcer (PPU) is a challenge for surgeons in Africa.<jats:italic>Aim</jats:italic>. To determine risk factors of postoperative complications or mortality among black Ivoirian patients with PPU.<jats:italic>Methods</jats:italic>. 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.<jats:italic>Results</jats:italic>. 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,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.03</mml:mn></mml:math>), tachycardia (pulse rate &gt; 100/minutes) (HR = 2.4,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.02</mml:mn></mml:math>), purulent intra-abdominal fluid collection (HR = 2.1,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.04</mml:mn></mml:math>), hyponatremia (median value ≤ 134 mEq/L) (HR = 2.3,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.01</mml:mn></mml:math>), delayed time of hospital admission &gt; 72 hours (HR = 2.6,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn fontstyle="italic">0.0001</mml:mn></mml:math>), and delayed time of surgical intervention between 24 and 48 hours (HR = 3.8,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn fontstyle="italic">0.0001</mml:mn></mml:math>).<jats:italic>Conclusion</jats:italic>. 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.</jats:p>
  • Access State: Open Access