Outcome and Associated Factors Among Patients Admitted With Perforated Peptic Ulcer in Dessie Referal Hospital: Document Review.

Abstract BackgroundPeptic ulcer disease is resulted from imbalances between aggressive factors such as stomach acid, pepsin and mucosa defense barriers. Potentially, associated with life-threatening complications, including bleeding, perforation, penetration, and obstruction. The magnitude and main reasons for this problem is not well known in north east Ethiopia specifically in Dessie referral hospital. ObjectiveTo determine outcomes and associated factors among patients admitted with perforated peptic ulcer disease at Dessie Referral Hospital.MethodsA retrospective cross sectional study was conducted in Dessie Referral Hospital by revising three years patient card registry data from June 1/ 2016 - May 30/2019 G.C and data were collected using data abstracting checklist. All patients for whom laparotomy were done for perforated peptic ulcer disease during the study period were included. After checking data for completeness entered and cleaned using Epi info version 7 and analyzed using SPSS version 25 and binary logistic regression model were used for testing the presence and strength of association. ResultA total of 101 patients were studied. Males outnumbered than females by a ratio of 19.2: 1. The mean age of patients (SD) was 36.05 (±16.56) years. Most perforations were located on the first part of duodenum 93 (92.1%). Among majority of respondents 98 (97%) had Graham’s omental patch of the perforations. There were fifty eight post-operative complications recorded in eighteen (17.8%) patients. Superficial surgical site infection (11.9%), wound dehiscence (6.9%), respiratory infections (14.9%), post-operative collections (7.9%), acute kidney injury (5%) and ECF (1%) complications were identified. Comorbidity [AOR: 9.6(1.451-62.432)], SBP<90mmHg [AOR: 4.82(1.292-17.803)] and age above 50 years [AOR: 6.05(1.612-22.601)] were significantly associated with post-operative complication of perforated peptic ulcer. Conclusion and recommendationComplication and mortality rates in this study were lower than other study findings. Advanced age, co-morbidities, late presentation and hypotension were most important factors affecting patient’s out come in perforated peptic ulcer disease. Referral system should be improved to early interventions for better outcome. Post-operative analgesic, chest physiotherapy and appropriate wound care may decrease post-operative complications of perforated peptic ulcer disease.