A Cross-Sectional study on Factors associated with perforated peptic ulcer disease in adults presesnted to the University Teachng Hospital,Lusaka

Abstract

Objective: To determine the various clinical and epidemiological factors associated with peptic ulcer perforation in adults at UTH.A pilot study for an impending broader controlled study. Design: A hospital-based cross-sectional study Participants: 35 adult patients all of whom were diagnosed at laparotomy as having perforated, benign peptic ulcers, confirmed histologically. Setting:, University Teaching Hospital, Lusaka, Zambia. Results: It was shown that there was a male preponderance (85.7%). The mean age was 39.9 years and the peak range to perforate was 16-45 years (68.6%). Most patients were Lusaka -based (82.8%),and came from a middle income background(62.8%).Clinically, the most frequent presenting complaint was abdominal pain(62.8%),and 57.2% of patients had symptoms lasting 24 hours or less. Furthermore, the commonest blood group was group O+ (33.2%), with 40% confirming history of use of NSAIDs. 57% were regular alcohol drinkers and 34% were cigarette smokers. Also, a further 32% of patients were found to be HIV positive and 84.2% had no previous peptic ulcer history. Gastric perforations were by far the commonest anatomical site (82.8%) followed by duodenal (14.3%). Postoperative hospital stay prolonging 10 days was 51.4% and 37% died after surgery. Conclusion: Perforated peptic ulcers occur more in males below 45 years old, most of whom are middle income earners and Lusaka -based. A third of the study group tested positive for HIV and more than half confirmed being regular alcohol drinkers. About a third confirmed smoking cigarettes. The majority of patients denied history of previous peptic ulcer disease. Nearly half the group confirmed usage of NSAIDs and about a third were Blood group O+. Gastric perforations were in the greater majority with half the patients prolonging hospital stay for more than 10 days. Mortality following surgery was high (37%). A larger study group ought to be recruited for definitive conclusions to be made.