Predictors of postoperative complications after surgery for perforated peptic ulcer: a prospective study from a tertiary center of Nepal

Introduction: Peptic ulcer disease (PUD) and its consequences are prevalent in developing countries. This study aimed to identify predictors of postoperative complications and mortality among patients undergoing emergency surgery for perforated peptic ulcer in the tertiary care center of Nepal. Methods: A prospective cohort study of consecutive adults undergoing emergency laparotomy with omental patch repair for perforated PUD was performed. Demographics, presentation variables, and perioperative data were recorded using a structured proforma. Predictors of complications and in-hospital mortality were assessed with logistic regression; results are reported as odds ratios (OR) with 95% confidence intervals (CI). Results: Among 85 patients (mean age 42 ± 15.4 years; 88% male), complications occurred in 42.4% and mortality in 5.9%. Age ≥60 years (adjusted OR 30.4, 95% CI 2.7–347.7; p = 0.006) and preoperative shock (adjusted OR 13.9, 95% CI 2–92.9; p = 0.006) were associated with higher odds of complications. Conclusion: Age ≥60 years and preoperative shock may help identify patients at higher risk of postoperative complications after perforated PUD repair. Given the small sample size and event constraints, these results are exploratory; multicenter validation with adequate power is warranted.