{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:52:47Z","timestamp":1790653967262,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perforated peptic ulcer remains one of the most common surgical emergencies in India with significant morbidity and mortality. The aim of this study was to identify the perioperative risk factors influencing the post\u2010operative morbidity and mortality in patients with perforated peptic ulcer disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five\u2010hundred patients who underwent surgery for perforated peptic ulcer in our institution in the preceding 8\u2009years were included in this observational retrospective study. Their clinical presentations, peri\u2010operative managements were studied and analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five hundred cases were analysed of which 96% were males. Mean age was 46.5\u2009years. A total of 160 patients had duodenal perforation and 328 had gastric perforation with a mean size of 8.6\u2009mm. Most patients (96.2%) underwent omental patch closure of the perforation with mean length of hospitalization being 14\u2009days. The most common major and minor postoperative complications were prolonged intubation and pulmonary complaints respectively. Re\u2010exploration was needed in 6.2% of cases with a post\u2010operative leak rate of 5.8%. Age &gt;60\u2009years, presence of comorbid illnesses, shock at presentation and perforation size &gt;1\u2009cm were identified as independent predictors of postoperative morbidity. Overall mortality was 11.6% while specific mortality among males and females were 11.8% and 5% respectively. Age &gt;60\u2009years, shock at presentation, presence of abdominal rigidity and size of perforation &gt;1\u2009cm were independent predictors of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Old age, comorbidities, shock at presentation, perforation size &gt;1\u2009cm, higher ASA grade, prolonged surgery and biliopurulent contamination &gt;500\u2009mL were independent predictors of both increased post\u2010operative morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.18831","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T01:43:31Z","timestamp":1703036611000},"page":"366-370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Spectrum of perforated peptic ulcer disease in a tertiary care hospital in South India: predictors of morbidity and mortality"],"prefix":"10.1111","volume":"94","author":[{"given":"Agarwal","family":"Shreya","sequence":"first","affiliation":[{"name":"Department of Surgery, Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research  Pondicherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathar","family":"Sahla","sequence":"additional","affiliation":[{"name":"Department of Surgery, Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research  Pondicherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balakrishnan","family":"Gurushankari","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Cancer Institute (Womens' Indian Association)  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4929-3189","authenticated-orcid":false,"given":"Madan","family":"Shivakumar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research  Pondicherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Rifai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research  Pondicherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Kate","sequence":"additional","affiliation":[{"name":"Department of Surgery, Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research  Pondicherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6435-421X","authenticated-orcid":false,"given":"Sathasivam","family":"Sureshkumar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research  Pondicherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thulasingam","family":"Mahalakshmy","sequence":"additional","affiliation":[{"name":"Department of Surgery, Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research  Pondicherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"219","article-title":"Peptic ulcer disease and Helicobacter pylori infection","volume":"115","author":"Narayanan M","year":"2018","journal-title":"Mo. 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