Yildirim et al reported risk factors for morbidity and mortality following perforation of a peptic ulcer. These can help to identify a patient who may benefit from more aggressive management. The authors are from Izmir Bozyaka Training and Research Hospital in Turkey.
Patient selection: perforated peptic ulcer
Mortality rate: approximately 5%
Predictors of mortality:
(1) age > 50 years
(2) co-morbid condition(s)
(3) perforation location (gastric or duodenal)
(4) omentoplasty
(5) Mannheim Peritonitis Index (MPI) > 21
Predictors of morbidity:
(1) age > 50 years
(2) co-morbid condition(s)
(3) symptom duration > 8 hours
(4) intra-abdominal fluid > 500 mL
(5) Mannheim Peritonitis Index (MPI) > 21
(6) diameter of perforation > 0.5 cm
(7) omentoplasty
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