Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2017; 23(14): 2566-2574
Published online Apr 14, 2017. doi: 10.3748/wjg.v23.i14.2566
Clinical characteristics of peptic ulcer perforation in Korea
Young Joo Yang, Chang Seok Bang, Suk Pyo Shin, Tae Young Park, Ki Tae Suk, Gwang Ho Baik, Dong Joon Kim
Young Joo Yang, Chang Seok Bang, Suk Pyo Shin, Tae Young Park, Ki Tae Suk, Gwang Ho Baik, Dong Joon Kim, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, South Korea
Author contributions: Bang CS designed research; Yang YJ, Bang CS, Shin SP, Park TY, Suk KT, Baik GH and Kim DJ performed research; Baik GH contributed new reagent/analytic tools; Yang YJ analyzed data; Yang YJ and Bang CS wrote the paper.
Institutional review board statement: This study was reviewed and approved by the institutional review board of Chuncheon Sacred Heart Hospital (2016-86).
Informed consent statement: Informed consent was exempted due to retrospective format of this study from institutional review board of Chuncheon Sacred Heart Hospital and patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Authors disclose no conflict-of-interest or financial relationship relevant to this publication.
Data sharing statement: Detailed data used in this study can be provided by the corresponding author if requested.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chang Seok Bang, MD, PhD, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Sakju-ro 77, Chuncheon 24253, Gangwon-do, South Korea. csbang@hallym.ac.kr
Telephone: +82-33-2405821 Fax: +82-33-2418064
Received: December 18, 2016
Peer-review started: December 20, 2016
First decision: January 10, 2017
Revised: January 17, 2017
Accepted: March 15, 2017
Article in press: March 15, 2017
Published online: April 14, 2017
Abstract
AIM

To elucidate the epidemiological characteristics and associated risk factors of perforated peptic ulcer (PPU).

METHODS

We retrospectively reviewed medical records of patients who were diagnosed with benign PPU from 2010 through 2015 at 6 Hallym university-affiliated hospitals.

RESULTS

A total of 396 patients were identified with postoperative complication rate of 9.1% and mortality rate of 0.8%. Among 174 (43.9%) patients who were examined for Helicobacter pylori (H. pylori) infection, 78 (44.8%) patients were positive for H. pylori infection, 21 (12.1%) were on non-steroidal anti-inflammatory drugs (NSAIDs) therapy, and 80 (46%) patients were neither infected of H. pylori nor treated by any kinds of NSAIDs. Multivariate analysis indicated that older age (OR = 1.09, 95%CI: 1.04-1.16) and comorbidity (OR = 4.11, 95%CI: 1.03-16.48) were risk factors for NSAID-associated PPU compared with non-H. pylori, non-NSAID associated PPU and older age (OR = 1.04, 95%CI: 1.02-1.07) and alcohol consumption (OR = 2.08, 95%CI: 1.05-4.13) were risk factors for non-H. pylori, non-NSAID associated PPU compared with solely H. pylori positive PPU.

CONCLUSION

Elderly patients with comorbidities are associated with NSAIDs-associated PPU. Non-H. pylori, non-NSAID peptic ulcer is important etiology of PPU and alcohol consumption is associated risk factor.

Keywords: Helicobacter pylori, Non-steroidal anti-inflammatory drugs, Peptic ulcer perforation, Stomach ulcer, Duodenal ulcer

Core tip: The incidence of complications of peptic ulcer has not been decreasing and only a few data is available about epidemiological characteristics and associated risk factors of perforated peptic ulcer. In a retrospective review of medical records from multicenter in Korea revealed that elderly patients with comorbidities were associated with non-steroidal anti-inflammatory drugs (NSAIDs)-associated peptic ulcer perforation and non-Helicobacter pylori (H. pylori), non-NSAID peptic ulcer is important etiology in the development of peptic ulcer perforation. In a multivariate logistic regression analysis, alcohol consumption was suspected to be associated risk factors for the development of non-H. pylori, non-NSAID peptic perforation.