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Multicentre trial of a perioperative protocol to reduce mortality in patients with peptic ulcer perforation.
- Source :
-
The British journal of surgery [Br J Surg] 2011 Jun; Vol. 98 (6), pp. 802-10. Date of Electronic Publication: 2011 Mar 25. - Publication Year :
- 2011
-
Abstract
- Background: Morbidity and mortality rates in patients with perforated peptic ulcer (PPU) remain substantial. The aim of the present study was to evaluate the effect of a multimodal and multidisciplinary perioperative care protocol on mortality in patients with PPU.<br />Methods: This was an externally controlled multicentre trial set in seven gastrointestinal departments in Denmark. Consecutive patients who underwent surgery for gastric or duodenal PPU between 1 January 2008 and 31 December 2009 were treated according to a multimodal and multidisciplinary evidence-based perioperative care protocol. The 30-day mortality rate in this group was compared with rates in historical and concurrent national controls.<br />Results: The 30-day mortality rate following PPU was 17·1 per cent in the intervention group, compared with 27·0 per cent in the three control groups (P = 0·005). This corresponded to a relative risk of 0·63 (95 per cent confidence interval 0·41 to 0·97), a relative risk reduction of 37 (5 to 58) per cent and a number needed to treat of 10 (6 to 38).<br />Conclusion: The 30-day mortality rate in patients with PPU was reduced by more than one-third after the implementation of a multimodal and multidisciplinary perioperative care protocol, compared with conventional treatment.<br />Registration Number: NCT00624169 (http://www.clinicaltrials.gov).<br /> (Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Clinical Protocols
Denmark epidemiology
Duodenal Ulcer mortality
Female
Hospital Mortality
Humans
Male
Middle Aged
Peptic Ulcer Perforation mortality
Perioperative Care methods
Reoperation
Stomach Ulcer mortality
Duodenal Ulcer surgery
Peptic Ulcer Perforation surgery
Stomach Ulcer surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2168
- Volume :
- 98
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The British journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 21442610
- Full Text :
- https://doi.org/10.1002/bjs.7429