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Perforated peptic ulcer: how to improve outcome?

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@article{a05e74c9fe694c8286b8eb82521d2d50,
title = "Perforated peptic ulcer: how to improve outcome?",
abstract = "Despite the introduction of histamine H2-receptor antagonists, proton-pump inhibitors and the discovery of Helicobacter pylori, both the incidence of emergency surgery for perforated peptic ulcer and the mortality rate for patients undergoing surgery for peptic ulcer perforation have increased. This increase has occurred despite improvements in perioperative treatment and monitoring. To improve the outcome of these patients, it is necessary to investigate the reasons behind this high mortality rate. In this review we evaluate the existing evidence in order to identify significant risk factors with an emphasis on risks that are preventable. A systematic review including randomized studies was carried out. There are a limited number of studies of patients with peptic ulcer perforation. Most of these studies are of low evident status. Only a few randomized, controlled trials have been published. The mortality rate and the extent of postoperative complications are fairly high but the reasons for this have not been thoroughly explained, even though a number of risk factors have been identified. Some of these risk factors can be explained by the septic state of the patient on admission. In order to improve the outcome of patients with peptic ulcer perforation, sepsis needs to be factored into the existing knowledge and treatment.",
keywords = "Anti-Inflammatory Agents, Non-Steroidal, Clinical Trials as Topic, Denmark, Duodenal Ulcer, Evidence-Based Medicine, Gastrectomy, Helicobacter Infections, Helicobacter pylori, Humans, Incidence, Meta-Analysis as Topic, Peptic Ulcer Perforation, Prevalence, Proton Pumps, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Smoking, Stomach Ulcer, Survival Rate",
author = "M{\o}ller, {Morten Hylander} and Sven Adamsen and Morten W{\o}jdemann and M{\o}ller, {Ann Merete}",
year = "2009",
month = "1",
day = "1",
doi = "10.1080/00365520802307997",
language = "English",
volume = "44",
pages = "15--22",
journal = "Scandinavian Journal of Gastroenterology",
issn = "0036-5521",
publisher = "Taylor & Francis",
number = "1",

}

RIS

TY - JOUR

T1 - Perforated peptic ulcer: how to improve outcome?

AU - Møller, Morten Hylander

AU - Adamsen, Sven

AU - Wøjdemann, Morten

AU - Møller, Ann Merete

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Despite the introduction of histamine H2-receptor antagonists, proton-pump inhibitors and the discovery of Helicobacter pylori, both the incidence of emergency surgery for perforated peptic ulcer and the mortality rate for patients undergoing surgery for peptic ulcer perforation have increased. This increase has occurred despite improvements in perioperative treatment and monitoring. To improve the outcome of these patients, it is necessary to investigate the reasons behind this high mortality rate. In this review we evaluate the existing evidence in order to identify significant risk factors with an emphasis on risks that are preventable. A systematic review including randomized studies was carried out. There are a limited number of studies of patients with peptic ulcer perforation. Most of these studies are of low evident status. Only a few randomized, controlled trials have been published. The mortality rate and the extent of postoperative complications are fairly high but the reasons for this have not been thoroughly explained, even though a number of risk factors have been identified. Some of these risk factors can be explained by the septic state of the patient on admission. In order to improve the outcome of patients with peptic ulcer perforation, sepsis needs to be factored into the existing knowledge and treatment.

AB - Despite the introduction of histamine H2-receptor antagonists, proton-pump inhibitors and the discovery of Helicobacter pylori, both the incidence of emergency surgery for perforated peptic ulcer and the mortality rate for patients undergoing surgery for peptic ulcer perforation have increased. This increase has occurred despite improvements in perioperative treatment and monitoring. To improve the outcome of these patients, it is necessary to investigate the reasons behind this high mortality rate. In this review we evaluate the existing evidence in order to identify significant risk factors with an emphasis on risks that are preventable. A systematic review including randomized studies was carried out. There are a limited number of studies of patients with peptic ulcer perforation. Most of these studies are of low evident status. Only a few randomized, controlled trials have been published. The mortality rate and the extent of postoperative complications are fairly high but the reasons for this have not been thoroughly explained, even though a number of risk factors have been identified. Some of these risk factors can be explained by the septic state of the patient on admission. In order to improve the outcome of patients with peptic ulcer perforation, sepsis needs to be factored into the existing knowledge and treatment.

KW - Anti-Inflammatory Agents, Non-Steroidal

KW - Clinical Trials as Topic

KW - Denmark

KW - Duodenal Ulcer

KW - Evidence-Based Medicine

KW - Gastrectomy

KW - Helicobacter Infections

KW - Helicobacter pylori

KW - Humans

KW - Incidence

KW - Meta-Analysis as Topic

KW - Peptic Ulcer Perforation

KW - Prevalence

KW - Proton Pumps

KW - Randomized Controlled Trials as Topic

KW - Risk Assessment

KW - Risk Factors

KW - Smoking

KW - Stomach Ulcer

KW - Survival Rate

U2 - 10.1080/00365520802307997

DO - 10.1080/00365520802307997

M3 - Journal article

VL - 44

SP - 15

EP - 22

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

IS - 1

ER -

ID: 32797542