ArticleUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2026
Evaluation of predictive factors for morbidity and mortality in patients undergoing surgery for peptic ulcer perforation.
Article in Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPeptic ulcer perforation (PUP) is a life-threatening complication with high mortality caused by the leakage of gastric contents into the peritoneal cavity, leading to peritonitis. Systemic inflammatory indices, such as the C-reactive protein (CRP)/lymphocyte ratio, neutrophil-to-lymphocyte ratio (NLR), and multi-inflammatory indices (MII), reflect inflammation severity. This study aimed to investigate the predictive value of the CRP/Lymphocyte ratio, NLR, platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and MII indices for estimating morbidity and mortality in patients undergoing surgery for PUP.
methodsThis retrospective analysis included 319 patients who underwent surgery for PUP between October 2012 and January 2025. Pre-operative inflammatory indices were calculated from laboratory data and correlated with post-operative complications, length of hospital stay, and mortality.
resultsHigher CRP/Lymphocyte ratio, PLR, MII-1, MII-2, and MII-3 values were associated with fatal outcomes (p<0.05). The MII-2 and MII-3 indices best predicted post-operative complications with superior area under the curve (AUC) values (AUC: 0.655, 0.661, respectively) (p<0.001). All analyzed markers were significantly elevated in patients with prolonged hospitalization. Notably, the MII-2 index and CRP/lymphocyte ratio showed balanced sensitivity and high specificity for predicting mortality (AUC: 0.780, 0.787, respectively) (p<0.001).
conclusionThe MII-2 index and CRP-to-lymphocyte ratio are strong predictors of mortality in PUP patients, whereas the MII-2 and MII-3 indices are most effective for predicting complications. Incorporating these easily calculated indices into clinical practice can enhance risk stratification and decision-making.
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