• Ida Lolle, MøllerMorten HylanderMHb Department of Intensive Care 4131 , Copenhagen University Hospital Rigshospitalet , Copenhagen , Denmark., and Steffen Jais Rosenstock.
• a Department of Gastroenterology, Surgical Unit , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark ;
• Scand. J. Gastroenterol. 2016 Oct 1; 51 (10): 1165-71.

ObjectiveMortality rates in complicated peptic ulcer disease are high. This study aimed to examine the prognostic importance of ulcer site in patients with peptic ulcer bleeding (PUB) and perforated peptic ulcer (PPU).Materials And MethodsDesigna nationwide cohort study with prospective and consecutive data collection.Populationall patients treated for PUB and PPU at Danish hospitals between 2003 and 2014.Datademographic and clinical data reported to the Danish Clinical Registry of Emergency Surgery.Outcome Measures90- and 30-d mortality and re-intervention.Statisticsthe crude and adjusted association between ulcer site (gastric and duodenal) and the outcome measures of interest were assessed by binary logistic regression analysis.ResultsSome 20,059 patients with PUB and 4273 patients with PPU were included; 90-d mortality was 15.3% for PUB and 29.8% for PPU; 30-d mortality was 10.2% and 24.7%, respectively. Duodenal bleeding ulcer, as compared to gastric ulcer (GU), was associated with a significantly increased risk of all-cause mortality within 90 and 30 d, and with re-intervention: adjusted odds ratio (OR) 1.47 (95% confidence interval 1.30-1.67); p < 0.001, OR 1.60 (1.43-1.77); p < 0.001, and OR 1.86 (1.68-2.06); p < 0.001, respectively. There was no difference in outcomes between gastric and duodenal ulcers (DUs) in PPU patients: adjusted OR 0.99 (0.84-1.16); p = 0.698, OR 0.93 (0.78 to 1.10); p = 0.409, and OR 0.97 (0.80-1.19); p = 0.799, respectively.ConclusionsDU site is a significant predictor of death and re-intervention in patients with PUB, as compared to GU site. This does not seem to be the case for patients with PPU.

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