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PubMed1990

[Perforated gastroduodenal ulcer. II. Risk analysis in the prognostic evaluation of the postoperative course].

The data of 245 patients of our clinic, which perforation was treated with simple suture, were analysed by uni- and multivariate statistics to estimate risk factors. The aim was to predict the postoperative outcome. In a first step univariate test methods gave some orientation of the relevance of the factors. There was a highly significant correlation of age, preoperative shock, medical illnesses, time interval perforation-operation and clinical diagnosis to postoperative mortality. In a second step a multivariate decision model was used to calculate a prognostic index of the outcome after operation of perforated peptic ulcer. The index was tested in a cohort study. The results of validation were good for all quality parameters, so that the index allows a relatively safer statement about the so-called risk patients.--The prognostic problems of perforated gastroduodenal ulcer, including diagnosis, are also represented with graphic figures in the form of decision trees.

Adolescent↗
PubMed1990

Changes in peptic ulcer and gastritis/duodenitis in Great Britain, 1970-1985.

The signal event of the 1970s in peptic ulcer disease was the introduction of H2 blockers. We examined changing direct and indirect effects of peptic ulcer and gastritis/duodenitis on the British population from 1970 to 1985. Death rates from gastric ulcer declined irregularly for all except women 65 years of age and older, in whom it increased, while for duodenal ulcer mortality declined only for men less than 65 years old and increased sharply for women 65 years and above. Mortality due to gastritis/duodenitis rose irregularly to 1980 and then fell inconsistently through 1985, and was but 1.0 to 1.5% that of peptic ulcer. Elderly women were disproportionately affected, much as with peptic ulcer. There was no significant change in essentially stable time trends for peptic ulcer perforation deaths. Hospitalizations for gastric and duodenal ulcer continued to fall through 1985 except for those age 65 years and above. Hospitalizations for peptic ulcer hemorrhage did not change overall, but the distribution favoring the elderly in the early 1970s reversed. Elderly men and women are now the most likely to bleed for both gastric and duodenal ulcer. Hospitalizations for gastritis/duodenitis increased for all populations. Peptic ulcer operations declined markedly for all groups, most for men and women less than 65 years old. Peptic ulcer as a cause of work loss declined sharply over time for men but was stable for women, while work loss due to gastritis/duodenitis plunged for both sexes beginning in 1979. Mean days off work per spell of absenteeism remained relatively constant: 35-45 days for peptic ulcer and 10-12 days for gastritis/duodenitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗