ANALYSIS OF FACTORS INFLUENCING DURATION OF HOSPITAL STAY IN GASTRODUODENAL ULCER PERFORATION

Park, Jong Kwon; Youn, Yeo Kyu

J Korean Soc Emerg Med > Volume 7(3); 1996 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1996;7(3): 363-373.

ANALYSIS OF FACTORS INFLUENCING DURATION OF HOSPITAL STAY IN GASTRODUODENAL ULCER PERFORATION

¹Department of Emergency Medicine, Seoul National University College of Medicine, Seoul Korea
²Department of Surgery, Seoul National University College of Medicine, Seoul Korea

Published online: September 30, 1996.

ABSTRACT

Delayed treatment of the perforated peptic ulcer causes high mortality and prolonged hospital stay especially in old aged patients. In spite of the improvement in surgical technique, medical facilities and various drugs over the past 50 years, mortality and morbidity remain relatively unchanged since the mid-1940s. Contrary to other prognostic variables(e.g., age, preoperative status, and coincidental disease), delayed treatment can be modified by emergency physician without special epuipments or expensive facilities. The problem of delay is particularly important because time from perforation to operation is the major determining factor of prognosis. To identify the risk factors that influence the duration of hospital stay after treatment of perforated peptic ulcer, we analysed 26 patients who had experienced operative treatments from January 1991 to December 1995 in Seoul National University Hospital retrospectively. Using Mann-Whitney U(Wilcoxon Rank Sum) and Kruskal-Wallis test, nine risk factors were analysed statistically. The site of perforation, delayed hours(more or less then 12hours), age, sex, white blood cell count(more or less then 10,000/mm3), preoperative renal function( more or less then 2.0 mg/dL of Creatinine), preoperative shock(systolic Blood Pressure more or less then 90mmHg), operative procedures and presence or absence of associated diseases. The duration of hospital stay was significantly prolonged in patients aged more than 49 years and when treatment was delayed over 12 hours.(p=0.0318, 0.0414) Other factors showed no significant differences. For the more favorable results, emergency physicians should take care of the patients to prevent delayed operation and keep prompt communication with surgeon.

Key words: Perforated peptic ulcer, Risk factors, Hospital stay