Skip to main content

Advertisement

Log in

Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these.

Method

We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality.

Results

 1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4–2), (OR = 4.7, 95% CI 3.1–7.6)], female gender [(OR = 1.8, 95% CI 1.4–2.3), (OR = 1.9, 95% CI 1.3–2.9)], shock on admission [(OR = 2.1, 95% CI 1.7–2.7), (OR = 4.8, 95% CI 3.2–7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9–3.2), (OR = 3.9), 95% CI 2.7–5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1–1.6], but not mortality.

Conclusions

This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Lanas A, Chan FKL (2017) Peptic ulcer disease. Lancet 390:613–624

    Article  PubMed  Google Scholar 

  2. Gabriel V, Grigorian A, Schubl SD, Pejcinovska M, Won E, Lekawa M et al (2018) Perforated Peptic ulcer surgery: decreased length of stay but no difference in mortality with laparoscopic repair. Surg Laparosc Endosc Percutan Tech 28(6):410–415

    Article  PubMed  Google Scholar 

  3. Daniel VT, Wiseman JT, Flahive J, Santry HP (2017) Predictors of mortality in the elderly after open repair for perforated peptic ulcer disease. J Surg Res 215:108–113

    Article  PubMed  PubMed Central  Google Scholar 

  4. Thorsen K, Søreide JA, Kvaløy JT, Glomsaker T, Søreide K (2013) Epidemiology of perforated peptic ulcer: age- and gender-adjusted analysis of incidence and mortality. World J Gastroenterol 19(3):347–354

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sivaram P, Sreekumar A (2018) Preoperative factors influencing mortality and morbidity in peptic ulcer perforation. Eur J Trauma Emerg Surg 44(2):251–257

    Article  CAS  PubMed  Google Scholar 

  6. Jayaraman SS, Allen R, Feather C, Turcotte J, Klune JR (2021) Outcomes of laparoscopic vs open repair of perforated peptic ulcers: an ACS-NSQIP study. J Surg Res 265:13–20

    Article  PubMed  Google Scholar 

  7. Leusink A, Markar SR, Wiggins T, Mackenzie H, Faiz O, Hanna GB (2018) Laparoscopic surgery for perforated peptic ulcer: an English national population-based cohort study. Surg Endosc 32(9):3783–3788

    Article  PubMed  Google Scholar 

  8. Siu WT, Leong HT, Law BKB, Chau CH, Li ACN, Fung KH et al (2002) Laparoscopic repair for perforated peptic ulcer a randomized controlled trial. Ann Surg 235(3):313–319

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bertleff MJOE, Lange JF (2010) Perforated peptic ulcer disease: a review of history and treatment. Digest Surg 27:161–169

    Article  Google Scholar 

  10. Ly WK, Bucher P, Oulhaci W, Morel P, Ris F, Huber O (2007) Results of conservative treatment for perforated gastroduodenal ulcers in patients not eligible for surgical repair. Swiss Med Wkly 137(23–24):337–340

    Google Scholar 

  11. Donovan AJ, Berne TV, Donovan JA (1998) Perforated duodenal ulcer an alternative therapeutic plan. Arch Surg 133(11):1166–1171

    Article  CAS  PubMed  Google Scholar 

  12. Cao F, Li J, Li A, Fang Y, Wang YJ, Li F (2014) Nonoperative management for perforated peptic ulcer: who can benefit? Asian J Surg 37(3):148–153

    Article  PubMed  Google Scholar 

  13. Donovan AJ, Berne TV, Donovan JA (1998) Perforated duodenal ulcer. Arch Surg 133(11):1166–1171

    Article  CAS  PubMed  Google Scholar 

  14. Costa G, Fransvea P, Lepre L, Liotta G, Mazzoni G, Biloslavo A et al (2023) Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach. Surg Endosc. https://doi.org/10.1007/s00464-023-09998-5

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ali AM, Mohamed AN, Mohamed YG, Keleşoğlu Sİ (2022) Clinical presentation and surgical management of perforated peptic ulcer in a tertiary hospital in Mogadishu, Somalia: a 5-year retrospective study. World J Emerg Surg 17(1):23

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bupicha JA, Gebresellassie HW, Alemayehu A (2020) Pattern and outcome of perforated peptic ulcer disease patient in four teaching hospitals in Addis Ababa, Ethiopia: a prospective cohort multicenter study. BMC Surg 20(1):135

    Article  PubMed  PubMed Central  Google Scholar 

  17. Alhaj Saleh A, Esquivel EC, Lung JT, Eaton BC, Bruns BR, Barmparas G et al (2019) Laparoscopic omental patch for perforated peptic ulcer disease reduces length of stay and complications, compared to open surgery: a SWSC multicenter study. Am J Surg 218(6):1060–1064

    Article  PubMed  Google Scholar 

  18. Ahmed M, Mansoor T, Rab AZ, Rizvi SAA (2022) Risk factors influencing postoperative outcome in patients with perforated peptic ulcer: a prospective cohort study. Eur J Trauma Emerg Surg 48(1):81–86

    Article  PubMed  Google Scholar 

  19. Noguiera C, Silva AS, Nunes Santos J, Gomes Silva A, Ferreira J, Matos E et al (2003) Perforated peptic ulcer: Main factors of morbidity and mortality. World J Surg 27(7):782–787

    Article  PubMed  Google Scholar 

  20. Lohsiriwat V, Prapasrivorakul S, Lohsiriwat D (2009) Perforated Peptic Ulcer: Clinical presentation, surgical outcomes, and the accuracy of the Boey scoring system in predicting postoperative morbidity and mortality. World J Surg 33(1):80–85

    Article  PubMed  Google Scholar 

  21. Zogovic S, Bojesen AB, Andos S, Mortensen FV (2019) Laparoscopic repair of perforated peptic ulcer is not prognostic factor for 30-day mortality (a nationwide prospective cohort study). Int J Surg 72:47–54

    Article  PubMed  Google Scholar 

  22. Byrne BE, Bassett M, Rogers CA, Anderson ID, Beckingham I, Blazeby JM (2018) Short-term outcomes after emergency surgery for complicated peptic ulcer disease from the UK National Emergency Laparotomy Audit: a cohort study. BMJ Open 8(8):e023721

    Article  PubMed  PubMed Central  Google Scholar 

  23. Johnson CH, McLean RC, McCallum I, Perren D, Phillips AW (2019) An evaluation of the epidemiology, management and outcomes for perforated peptic ulcers across the North of England over 15 years: a retrospective cohort study. Int J Surg 64:24–32

    Article  PubMed  Google Scholar 

  24. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  25. Peiffer S, Pelton M, Keeney L, Kwon EG, Ofosu-Okromah R, Acharya Y et al (2020) Risk factors of perioperative mortality from complicated peptic ulcer disease in Africa: systematic review and meta-analysis. BMJ Open Gastroenterol (BMJ) 7(1):e000350

    Article  Google Scholar 

  26. Wilhelmsen M, Møller MH, Rosenstock S (2015) Surgical complications after open and laparoscopic surgery for perforated peptic ulcer in a nationwide cohort. Br J Surg 102(4):382–387

    Article  CAS  PubMed  Google Scholar 

  27. Taş I, Ülger BV, Önder A, Kapan M, Bozdaʇ Z (2015) Risk factors influencing morbidity and mortality in perforated peptic ulcer disease. Turk J Surg 31(1):20–25

    Article  Google Scholar 

  28. Yalcin M, Oter S, Akınoğlu A (2022) Peptik ülser perforasyonunda erken ameliyat sonrası morbidite ve mortalite belirleyicileri. Ulus Travma Acil Cerrahi Derg 28(11):1558–1562

    PubMed  PubMed Central  Google Scholar 

  29. Bas G, Eryilmaz R, Okan I, Sahin M (2008) Risk factors of morbidity and mortality in patients with perforated peptic ulcer. Acta Chir Belg 108(4):424–427

    Article  CAS  PubMed  Google Scholar 

  30. Christensen S, Riis A, Nørgaard M, Sørensen HT, Thomsen RW (2007) Short-term mortality after perforated or bleeding peptic ulcer among elderly patients: a population-based cohort study. BMC Geriatr 7:8

    Article  PubMed  PubMed Central  Google Scholar 

  31. Vărcuş F, Beuran M, Lica I, Turculet C, Cotarlet AV, Georgescu S et al (2017) Laparoscopic repair for perforated peptic ulcer: a retrospective study. World J Surg 41(4):948–953

    Article  PubMed  Google Scholar 

  32. Kim JM, Jeong SH, Lee YJ, Park ST, Choi SK, Hong SC et al (2012) Analysis of risk factors for postoperative morbidity in perforated peptic ulcer. J Gastric Cancer 12(1):26–35

    Article  PubMed  PubMed Central  Google Scholar 

  33. Bejiga G, Negasa T, Abebe A (2022) Treatment outcome of perforated peptic ulcer disease among surgically treated patients: a cross-sectional study in Adama hospital medical college, Adama. Ethiopia Int J Surg Open 48:100564

    Article  Google Scholar 

  34. Wright GP, Davis AT, Koehler TJ, Scheeres DE (2014) Cost-efficiency and outcomes in the treatment of perforated peptic ulcer disease: laparoscopic versus open approach. Surgery 156(4):1003–1008

    Article  PubMed  Google Scholar 

  35. Testini M, Portincasa P, Piccinni G, Lissidini G, Pellegrini F, Greco L (2003) Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer. World J Gastroenterol 9(10):2338–2340

    Article  PubMed  PubMed Central  Google Scholar 

  36. Buck DL, Vester-Andersen M, Møller MH (2013) Surgical delay is a critical determinant of survival in perforated peptic ulcer. Br J Surg 100(8):1045–1049

    Article  CAS  PubMed  Google Scholar 

  37. Lau WY, Leung KL, Kwong KH, Davey IC, Robertson C, Dawson JJW et al (1996) Perforated peptic ulcer using suture or sutureless technique. Ann Surg 224:131–138

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Collaborators of GRACE Study Collaborative Group: Mohd Firdaus Bin A. Karim, Mathiban Raj A/L A. Muthu Raju, Amaar Aamery, Ashraf Abbass, Saedah Abdeewi, Ali Hussien Abdelaal, Meriem Abdoun, Naimat Ullah Abdul Rahim, Eman Ali Abdulwahed, Rashad Abizade, Mohammad Abu-Jeyyab, Jose M. Aceves-Ayala, Preeti Acharya, Débora Acín-Gándara, Ademola A. Adeyeye, Md Tanveer Adil, Peter Ikponmwosa Agbonrofo, Mabroukah Abraheem Ahjaaz, Zarka Ahmad, Omer Akay, Basim Al-Robaie, Manar Al-Shami, Nadeem B. Alabdallah, Mohammad Aldaher, Alaa Aldirani, Nassir Alhaboob, Alya Alhadi, Qamar Alhaj Ali, Altayeb Alhaj Zain, Mohammed Alharthi, Ahmad Alhashash, Ahmad Ali Ali, Abd Alwahab Alkhalaf, Nigar Allahverdiyeva, Sarah Almaqdi, Hala Almohi Alsaid Mushaweh, Mohammad Aloulou, Sarah Alsafi, Entisar Ahmed Alshareea, Mohamed Alsori, Ahmad Fais Mukriz Alwi, Mohamed Mourad Aly, Kenechukwu David Amaefuna, Farhah Asilah Binti Amer, Bashiru Aminu, Elissavet Anestiadou, Dragana Arbutina, Aziz Ari, Nikolaos Arkadopoulos, Kemal Arslan, Kriscia V. Ascencio-Díaz, Evelia Verónica Romo Ascencio, Alan Askari, Nora Ra'ed Abdullah, Atiah Rawdah Attoum, Jethro Atumanyire, Victor J. Avalos- Herrera, Selmy S. Awad, Ahmed Azam, Sarmad Saeed Aziz, Jomana Sami Azouz, Marwen Baccar, Marwa Mohamed Ali Badawi, Sharhanim Binti Bahrudin, Hibah Bileid Bakeer, Zoe Bakewell, Aditya Baksi, Mohammed Balbola, Andrea Balla, Maria Balluerca, José Adelino Laborinhas Barbosa, Laura Elisabete Ribeiro Barbosa, Francisco J. Barbosa-Camacho, Ana Lúcia Barreira, Katarzyna Bartosiak, Mohammed Basendowah, Magdy Basheer, Mutiu Adebayo Bashiru, Somprakas Basu, Zachary Baxter, José Antonio Becerra Toro, Usman Mohammed Bello, Olga Bellou, Domenico Benavoli, Alyson Bermingham, Bhavneet Singh Bhalla, Muhannud Hassan Binnawara, Alex Boddy, Joana S. Bolota, Luca Bonatti, Alessandro Michele Bonomi, Zdenko Boras, Manar M.Bouaoud Bouaoud, Souad Bouaoud, Kamel Bouchenak, Sarah Bowman, Haktan Övül Bozkır, Irma V. Brancaccio-Pérez, Marta Breda, Giacomo Carganico, Clifford Caruana, Danilo Centonze, Gabino Cervantes-Guevara, Enrique Cervantes-Pérez, Jeyadurga C. Chandramohan, Mohamed Ali Chaouch, Nicola Cillara, Brigitta Cismasiu, Christian Cotsoglou, Ben Creavin, Fabrizio D'acapito, Nour A. Dalloul, Giovanni Dapri, Dragomir Dardanov, Bhuban Mohan Das, Maurizio De Luca, Luca Degrate, Jonathan Abraham Demma, Khawla Derwish, Costanza Distefano, Agron Dogjani, Zhiyong Dong, Claire Donohoe, Panagiotis Dorovinis, Anne Sophie Dulac, Helen Earley, Sanketh Edem, Michael El Boghdady, Mohamed A. El Sayed, Ahmed H El Shamarka, Tarek I. El-Houssari, Peter Oluwatobi Elemile, Khamis Elessi, Hosam M. Elghadban, Laila Kamel Elgherwi, Ahmed E. Elghrieb, Mayar El-Haddad, Muhammed Elhadi, Ahmed Mohammed Elshaer, Ikenna Cletus Emejulu, Ghada Enani, Giorgio Ercolani, Ergin Erginöz, Suraj Ethiraj, Giuseppe Evola, Syaza Najwa Binti Faizul, Daniel Moritz Felsenreich, Melissa A. Fernandez Zurita, Federico Festa, Alessia Fiore, Yuri Fishman, Muratcan Fırat, Mimia Fouadla, Massimo Framarini, Francesco Frattini, Clotilde Fuentes-Orozco, Farah Gahramanova, Laurent Genser, Farid Gerges, Ioannis N. Gerogiannis, Ahmed Abdualla S. Gerwash, Munir Ghandour, Ahmad Ghazal, Mohamad Ghazal, Ali Abdullah Gill, Hana Yousef Gineeb, Rossella Gioco, Nakul Gokhare Viswanath, Ricardo A. T. Gonsaga, Alejandro González- Ojeda, Fanny Y.González-Ponce, Aakansha Giri Goswami, Yitka Graham, Stefano Granieri, Jan Grosek, Rahul Gupta, Amit Gupta, Deniz Güzey, Bertha G. Guzmán-Ramírez, Mario J. Guzmán- Ruvalcaba, Sana Hamayun, Hytham K. S. Hamid, Abdul Rahman Hammadieh, Abdallatef Hasan, Abdul Haseeb, Siti Rahmah Hashim Isa Merican, İsmail Hasırcı, Eric J. Hazebroek, Susana Henriques, Farhanul Huda, Silvia A. Ibarra-Camargo, Ufuk Oguz Idiz, Kelly Iles, Orestis Ioannidis, Solomon N. Irmiya, Vikas Jain, Azalea Jan, Christopher Jones, Nicholas Jimbun Anak Juli, Abram Calinton Bin Justin, Stylianos Kapiris, Panagiotis Kapsampelis, Supreet Kaur, Alfie J. Kavalakat, Ahmad Amir H. Kayali, Myrto D. Keramida, Amir Hamza Khan, Archana Khanduri, Rama Khatib, Shehrbano Khattak, Choon Keat Kim, Guowei Kim, Panagiotis Kokoropoulos, Katarzyna Komorowska, Jurij A. Košir, Angeliki Kosti, Aya Tinhinane Kouicem, Aya Tinhinane A.Kouicem, Bojan Kovacevic, Shyam Karuppusamy Krishnasamy, Rabia Kucukarslan Guler, Navin Kumar, Mikhail Kurtenkov, Stylianos Kykalos, Hampher Kynjing, Pierfrancesco Lapolla, Mohammed Hakim Larbi, Omar Lasheen, Wan Teng Lee, Pasquale Lepiane, Alessio Licciardello, Rita Rmp Lima, Enrico Lodo, Zbigniew Lorenc, Waleed Mabood, Nikolaos Machairas, Brij Madhok, Mohamed Shafi Mahboob Ali, Ahmed S. Mahdi, Hasan Mahmoud, Nadim Malibary, Dhiraj Mallik, Shabnam Mammadova, Luka Mandic, Roberto Mares-País, Gad Marom, Cláudia Neves Marques, Ruqaya J. Masri, Pietro Masseria, Annabel M. Mclean, Mohd Nizam Md Hashim, Mohd Adlan Bin Md Kamal, Manuel Medina-García, Aissam Megaache, Mel P. Mellado-Tellez, Adriel C. Meneghello, Nikolaos V. Michalopoulos, Andrea Mingoli, Mohamed Salah Mohalal, Ikhwan Sani Mohamad, Salma Tarek Mohamed, Maimuna Zahra Binti Mohamed Fadzil, Almarri Mohammad, Mauro Montuori, Damián Mora-Santana, Dimitrios Moris, Arinzechukwu O. Mosanya, Vasileios Mousafeiris, Alaa Mousli, Odysseas Mouzakis, Aiman Nuri Muftah, Francesk Mulita, Theodore F. Nabavi, Areej Esam Aish Nadeesh, Rodrigo Nájar-Hinojosa, Mahfoud Najjar, Mohannad Nasani, Constantinos Nastos, Peter M. Neary, Ahmed R. Negm, Itzel Ochoa-Rodríguez, Stefano Olmi, Steve-Nation Nehiweze Oriakhi, Ana P. Orozco-Gallardo, Monday Omoruyi Osarenkhoe, Amel A. Ouyahia, Mehmet Faik Özçelik, Zeynep Özdemir, Ferman Tevfik Özyalvaç, Dimitrios Papaconstantinou, Francesco Saverio Papadia, Maria Papadoliopoulou, Aristeidis Papadopoulos, Christos Papazacharias, Chetan Parmar, Patricia Paunero, G. Pawan, Rocío Pérez Quintero, Enrico Pinotti, Adolfo Pisanu, Sunil Popat, Dimitri Pournaras, Sjaak Pouwels, Omar Qassab, Francesco Quaglino, Anbarasan Rasadurai R. Anbarasan, Mubashir Rafique, Atiqur Rahman, Mounira M. Rais, Malairman R. Rajayokiam, Deepak Rajput, Rosnelifaizur Ramely, Luis R. Ramirez-Gónzalez, Gopi Ramu, Nawwar Reslan, Giordana Riccioli, Vakulabharanam Naga Rohith, Kimutai S. Ronoh, Homayoon Roshan, Cornelio Ruelas-Bravo, Elena Ruiz-Úcar, Alifa Sabir, Nait Ali Sabrin, Ahmed Abdelfattah Sabry, Mehmet Emin Şahin, Amira Said, Nasser Sakran, Yara M. Salem, Syahrul Anuar Salleh, Virginia Sangpliang, Dina Hesham Sapry, Francesca Maria Chiara Savasta, Khaled Ahmad Sawaftah, Juan Pablo Scarano Pereira, Dimitrios Schizas, Husnu Sevik, Asim Shabbir, Ahmad Shahroz, Haitam Shames, Ankur Sharma, Sahil Shet, Mohamed S. Shetiwy, Ashraf Shoma, Fakhar Munir Sial, Theodoros A. Sidiropoulos, Sudhir Kumar Singh, Jimmy Bok Yan So, Jien Yen Soh, Leonardo Solaini, Stefania Soncini, Enas Soula, Fabiana Filipa Silva Sousa, Ludovica Stella, Luis O. Suárez-Carreón, Dhivakar Sugumar, Mohamed Swamad, Athanasios Syllaios, Savvas Symeonidis, Benali Tabeti, Ekaterini Christina Tampaki, Nicola Tartaglia, Yen Zhir Tay, Tengku Nazim Bin Tengku Yusof, Nilanjana Tewari, Anisse Tidjane, Beatrice Torre, Matteo Uccelli, Fara M.L. Uccelli, Server Sezgin Uludağ, Mehmet Eşref Ulutaş, Bashir Musa Umar, Hyeladi Malgwi Usman, Anthony Uwuigbe, Michail Vailas, Susan Sofia Gonçalves Vaz, Jesús O. Vega-Gastelum, Massimiliano Veroux, Yirupaiahgari K. S. Viswanath, Ivan Vlahović, Maciej Walędziak, Wan Mokhzani Wan Mokhter, Wan Zainira Wan Zain, Huaxi Wang, Hisham H. Warda, Zhuoqi Wei, Michael Pak-Kai Wong, Geoffrey Yuet Mun Wong, Maya Mazuwin Yahya, Wah Yang, Michael S. Yule, Zaidi Zakaria, Andee Dzukarnaen Zakaria, Maria F. Zarate-Casas, Kağan Zengin, Junchang Zhang.

Funding

No funding has been received.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to Mohamed Abouelazayem.

Ethics declarations

Disclosures

Mohamed Abouelazayem, Rajesh Jain, Michael SJ Wilson, Alessandro Martinino, Vignesh Balasubaramaniam, Walter Biffl, Federico Coccolini, Manel Riera, Himanshu Wadhawan, Ishaan Wazir, Bettahar Abderaouf, Daniil Abramov, Mustafa A. Abu Jayyab, Khayry Al-Shami, Ahmad Alfarwan, Faris M. Alhajami, Akram Alkaseek, Ous Alozairi, Ahmed Siddique Ammar, Burak Atar, Gan-Erdene Baatarjav, Lovenish Bains, Ashraf Bakri, Nuru Bayramov, Rajesh Bhojwani, Gioia Brachini, Giacomo Calini, Michela Campanelli, Shi Yu Cheng, Charan Singh Choudhary, Sharfuddin Chowdhury, Elif Colak, Jayanta Kumar Das, Surrendar Dawani, Turgut Dönmez, Ibrahim Elzayat, Sarnai Erdene, Tashaba Qaiser Faizi, Maximos Frountzas, Besma Gafsi, Paolo Gentileschi, Mert Guler, Gaurav Gupta, Nour Elhouda Harkati, Matthew Harris, Doaa M. Hasan, Omorodion Omoruyi Irowa, Salman Jafferi, Sumita Agarwal Jain, Lai Jun Han, Satyanarayana Murthy Kandiboyina, Mehmetu Karabulut, Almu’atasim Khamees, Shahzeb Khan, Madiha Masood Khan, Cheng Jing Khaw, Michal Kisielewski, Mohamad Klib, Jurij A. Košir, Wiktor Jan Krawczyk, Giorgio Lisi, Jerry Godfrey Makama, Baila Maqbool, Cláudia Neves Marques Serhat Meric, Mateusz Przemysław Mietła, Alaa Mohamed Ads, Joshua Muhumuza, Francesk Mulita, Matanat Mustafayeva, Mohammed A. Omar, Taryel Omarov, Akshant Anil Pathak, Ratnadeep Paul, Giovanna Pavone, Mauro Podda, Novinth Kumar Raja Ram, Fatima Rauf, Sidra Rauf, Ahmed Mohamed Safy, Erdene Sandag, Ahmet Necati Şanlı, Adeela Z. Siddiqui, Maria Sotiropoulou, Vikash Talib, Cihad Tatar, Anuroop Thota, Merve Tokocin, Aditya Tolat, Petar Angelov Uchikov, José I. Valenzuela, Sunil Kumar Venkatappa, Georgios-Ioannis Verras, Ivan Vlahović, Dafer Abdulhakim S. Zreeg, Victor Roth Cardoso, Georgios V. Gkoutos, Rishi Singhal, Kamal Mahawar, GRACE Study Collaborative Group have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The collaborators of GRACE Study Collaborative Group are listed in Acknowledgements section.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 118 KB)

Supplementary file2 (DOCX 29 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abouelazayem, M., Jain, R., Wilson, M.S.J. et al. Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study. Surg Endosc 38, 4402–4414 (2024). https://doi.org/10.1007/s00464-024-10881-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-024-10881-0

Keywords

Navigation