Chung KT, Shelat VG. Perforated peptic ulcer – an update. World J Gastrointest Surg. 2017 Jan 27;9(1):1-12. doi: 10.4240/wjgs.v9.i1.1.
Mortality is a serious complication in PPU. As we mentioned before, PPU carries a mortality ranging from 1.3% to 20%[9,10]. Other studies have also reported 30-d mortality rate reaching 20% and 90-d mortality rate of up to 30%[11,12].
Significant risk factors that lead to death are presence of shock at admission, co-morbidities, resection surgery, female, elderly patients, a delay presentation of more than 24 h, metabolic acidosis, acute renal failure, hypoalbuminemia, being underweight and smokers[11,127-131]. The mortality rate is as high as 12%-47% in elderly patients undergoing PPU surgery[132-134]. Patients older than 65 year-old were associated with higher mortality rate when compared to younger patients (37.7% vs 1.4%)[131]. A study involving 96 patients with PPU also showed that there was a ninefold increase in postoperative complications in patients with comorbidities[119]. In another large population study, patients with diabetes had significantly increased 30-day mortality from PPU[135]. (Chung, 2017, p. 8)
