Are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers?
Background: The study aimed to calculate the predictive value of admission laboratory values in patients with perforated peptic ulcers. Methods: A retrospective, cohort analytical, observational study was performed, including patients with surgically confirmed perforated peptic ulcers over a 5-year...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Surgery Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845022000768 |
| _version_ | 1797944061077749760 |
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| author | Wikus W. Mulder, MBChB, MMed (Surg), FCS (SA) Emmanuel Arko-Cobbah, MBChB, MMed (Surg), Cert Trauma Surgery (SA) Gina Joubert, MSc |
| author_facet | Wikus W. Mulder, MBChB, MMed (Surg), FCS (SA) Emmanuel Arko-Cobbah, MBChB, MMed (Surg), Cert Trauma Surgery (SA) Gina Joubert, MSc |
| author_sort | Wikus W. Mulder, MBChB, MMed (Surg), FCS (SA) |
| collection | DOAJ |
| description | Background: The study aimed to calculate the predictive value of admission laboratory values in patients with perforated peptic ulcers. Methods: A retrospective, cohort analytical, observational study was performed, including patients with surgically confirmed perforated peptic ulcers over a 5-year period. Demographic data and admission laboratory values were collected from hospital electronic databases. Outcomes measured were in-hospital mortality, intensive care unit (ICU) admission and length of stay. The significance of categorical variables was calculated by chi-square and Fisher's exact test. Logistic regression analysis was performed to determine univariately statistically significant variables. Results: In total, 188 patients met the inclusion criteria. The median age was 46 (range 15–87) years with a male predominance of 71.3 % (n = 134). The median length of hospital stay was 7 (range 1–94) days and 31.4 % (n = 59) of patients were admitted to the ICU. Post-operative in-hospital mortality was 25.0 % (n = 47). Predicting the categorical outcome of in-hospital mortality, abnormal haemoglobin, platelet count, urea, creatinine and potassium levels were all found to be statistically significant in the univariate analysis. Age (odds ratio [OR] 1.03), haemoglobin (OR 4.36) and creatinine (OR 7.76) levels were significant in the multivariate analysis. Conclusions: Mortality rate among patients with perforated peptic ulcer disease is still substantial. Admission laboratory values showed statistical significance as outcome indicators and were valuable to assist in predicting the prognosis. An abnormally high serum creatinine level was the strongest single predictor of both mortality and ICU admission. Key message: Initial laboratory findings of patients admitted for perforated peptic ulcer showed that an abnormally high serum creatinine level was the strongest single predictor of both mortality and ICU admission. |
| first_indexed | 2024-04-10T20:33:41Z |
| format | Article |
| id | doaj.art-2e04bcb71db24e8183725151fdd267c7 |
| institution | Directory Open Access Journal |
| issn | 2589-8450 |
| language | English |
| last_indexed | 2024-04-10T20:33:41Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj.art-2e04bcb71db24e8183725151fdd267c72023-01-25T04:16:10ZengElsevierSurgery Open Science2589-84502023-01-01116268Are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers?Wikus W. Mulder, MBChB, MMed (Surg), FCS (SA)0Emmanuel Arko-Cobbah, MBChB, MMed (Surg), Cert Trauma Surgery (SA)1Gina Joubert, MSc2Department of Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa; Corresponding author at: Department of Surgery, Faculty of Health Sciences, University of the Free State, 2015 Nelson Mandela Drive, Bloemfontein 9300, South Africa.Department of Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South AfricaDepartment of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South AfricaBackground: The study aimed to calculate the predictive value of admission laboratory values in patients with perforated peptic ulcers. Methods: A retrospective, cohort analytical, observational study was performed, including patients with surgically confirmed perforated peptic ulcers over a 5-year period. Demographic data and admission laboratory values were collected from hospital electronic databases. Outcomes measured were in-hospital mortality, intensive care unit (ICU) admission and length of stay. The significance of categorical variables was calculated by chi-square and Fisher's exact test. Logistic regression analysis was performed to determine univariately statistically significant variables. Results: In total, 188 patients met the inclusion criteria. The median age was 46 (range 15–87) years with a male predominance of 71.3 % (n = 134). The median length of hospital stay was 7 (range 1–94) days and 31.4 % (n = 59) of patients were admitted to the ICU. Post-operative in-hospital mortality was 25.0 % (n = 47). Predicting the categorical outcome of in-hospital mortality, abnormal haemoglobin, platelet count, urea, creatinine and potassium levels were all found to be statistically significant in the univariate analysis. Age (odds ratio [OR] 1.03), haemoglobin (OR 4.36) and creatinine (OR 7.76) levels were significant in the multivariate analysis. Conclusions: Mortality rate among patients with perforated peptic ulcer disease is still substantial. Admission laboratory values showed statistical significance as outcome indicators and were valuable to assist in predicting the prognosis. An abnormally high serum creatinine level was the strongest single predictor of both mortality and ICU admission. Key message: Initial laboratory findings of patients admitted for perforated peptic ulcer showed that an abnormally high serum creatinine level was the strongest single predictor of both mortality and ICU admission.http://www.sciencedirect.com/science/article/pii/S2589845022000768Peptic ulcerPerforationEmergency surgeryMortalityLaboratory values |
| spellingShingle | Wikus W. Mulder, MBChB, MMed (Surg), FCS (SA) Emmanuel Arko-Cobbah, MBChB, MMed (Surg), Cert Trauma Surgery (SA) Gina Joubert, MSc Are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers? Surgery Open Science Peptic ulcer Perforation Emergency surgery Mortality Laboratory values |
| title | Are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers? |
| title_full | Are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers? |
| title_fullStr | Are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers? |
| title_full_unstemmed | Are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers? |
| title_short | Are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers? |
| title_sort | are admission laboratory values in isolation meaningful for predicting surgical outcome in patients with perforated peptic ulcers |
| topic | Peptic ulcer Perforation Emergency surgery Mortality Laboratory values |
| url | http://www.sciencedirect.com/science/article/pii/S2589845022000768 |
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