BACKGROUND: Despite modern medications for peptic ulcers, @entity1 frequently require emergency surgery for complications of @entity1066 . Many of these @entity1 have coexisting medical problems which not only predispose to perforated @entity1066 , but also influence the clinical outcome. This study reviews the outcome of a group of @entity1 with perforated @entity1066 and examines the influence of a range of comorbidity factors on the outcome. METHODS: A retrospective chart review of all cases of perforated peptic occurring over a period of 9 years. RESULTS: One hundred and forty-nine perforated peptic ulcers in 147 @entity1 were diagnosed between 1987 and 1996. @entity5 , use of immunosuppressives or @entity288 , pre-operative shock and admission to intensive care were all significantly associated with reperforation by univariate analysis. However, logistic regression analysis indicated that none of these factors independently predicted reperforation which, therefore, occurs as a multifactorial event with all the above factors contributing. Death from perforated @entity1066 was related to pre-operative shock, @entity5 , admission to intensive care and reperforation when examined by univariate analysis. Furthermore, logistic regression analysis showed that coexisting @entity5 and reperforation were significant predictors of mortality. CONCLUSIONS: Perforated peptic @entity1066 remains a frequent clinical problem in @entity1 with short dyspeptic histories, who may or may not have been using ulcerogenic medications. It is a significant cause of morbidity and mortality among an often aged and otherwise unwell group of @entity1 . @entity1 with underlying @entity5 , who may be immunosuppressed with corticosteroids or cytotoxics, are at increased risk of dying from perforated @entity1066 . Reperforation of an @entity1066 , following simple closure or conservative treatment, is also highly predictive of increased mortality.

Predicting poor outcome in perforated peptic XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcer', 'ulcer disease'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Coexisting malignancy', 'malignant disease', 'malignancy'] @entity288 :: ('MESH:D000305', 'Chemical') :: ['corticosteroids']
@entity1066 :: (MESH:D014456,Disease) :: ['ulcer disease']
