Clinical Outcome and Factors Related in Patients with Perforated Peptic Ulcer at a South Indian Tertiary Care Hospital

Background: Significant morbidity and mortality are linked to perforated peptic ulcers (PPU), especially in low- to middle-income nations. The purpose of this study was to examine the clinical outcome of PPU patients and identify factors that could be altered to enhance outcomes. Methods: A retrospective analysis was conducted on the hospital's case sheet database in Medical Records department (MRD) after getting approval from Ethics committee. The cohort for analysis consisted of all patients at our hospital who received a PPU diagnosis between January 2023 and November 2024. The variables collected include age, comorbid profile, Boey score, type of surgery performed and complications. The study comprised patients with a confirmed single diagnosis of perforated peptic ulcer disease who were 13 years of age or older. Results: A total of 182 patients were part of the cohort. The mean age was 45 years, and the male to female ratio was 5:1. The most prevalent comorbidity was hypertension, and the only known risk factor for PUD was non-steroidal anti-inflammatory drugs. Pre-pyloric ulcers were most common in 60.4% of the study participants, followed by duodenal ulcers in 23.07% and stomach ulcers in 16.4%. In 82.6% of patients who had surgical treatment, omental patch repair was the most frequent operative procedure, followed by primary closure in 17.4%. Eighty percent of the patients in this study who did not need relaparotomy underwent an omental patch during their index procedure, while twenty percent underwent primary closure and debridement. None of the patients had a Boey score of 0. Conclusion: The Boey score was a strong predictor of both death and leak rate in our PPU patients. Although adding age as a variable could aid in mortality prediction in our context, more study is required to completely comprehend the clinical implications.