Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective Study

<i>Background and Objectives:</i> Perforated peptic ulcers are a common surgical emergency and rank among the leading causes of acute peritonitis worldwide. Previous studies have suggested a seasonal pattern in the occurrence of symptomatic perforated peptic ulcers. With the advancement...

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Main Authors: Iva Krajnović, Zenon Pogorelić, Iva Perić, Marija Ćavar, Matija Borić
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/6/945
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author Iva Krajnović
Zenon Pogorelić
Iva Perić
Marija Ćavar
Matija Borić
author_facet Iva Krajnović
Zenon Pogorelić
Iva Perić
Marija Ćavar
Matija Borić
author_sort Iva Krajnović
collection DOAJ
description <i>Background and Objectives:</i> Perforated peptic ulcers are a common surgical emergency and rank among the leading causes of acute peritonitis worldwide. Previous studies have suggested a seasonal pattern in the occurrence of symptomatic perforated peptic ulcers. With the advancement of modern medicine, including the widespread use of proton pump inhibitors, and the effects of climate change, this study aimed to assess potential seasonal variations in the incidence of peptic ulcer perforation in our region. <i>Methods:</i> This retrospective analysis included 104 adult patients (mean age: 61.5 ± 14.7 years) who underwent surgical treatment for peptic ulcer perforation between January 2021 and April 2024. Patients were analyzed by gender, age, risk factors (smoking and alcohol consumption), the location of the perforation (gastric or duodenal), and discharge outcome (survived or deceased). Additionally, cases were categorized by the month and season of the ulcer perforation. <i>Results</i>: Among the 104 patients (mean age 61.5 ± 14.7 years), 68 (65.4%) were male. Gastric and duodenal perforations were nearly equally observed (51% vs. 49%). A statistically significant difference in overall perforation rates by gender was observed (<i>p</i> = 0.009), though not between ulcer sites (<i>p</i> = 0.628 and <i>p</i> = 0.739). The highest number of perforations occurred in July (<i>n</i> = 12), while the lowest occurred in November (<i>n</i> = 4); however, no significant variation was found by month (<i>p</i> = 0.916) or season (<i>p</i> = 0.891), despite a predominance in spring. Comorbidities were present in 60% of patients. Smoking (33.6%) and alcohol use (22.1%) were common. Alcohol abuse was noted in 22.1% of patients and was significantly associated with both gastric (<i>p</i> < 0.001) and duodenal (<i>p</i> < 0.001) perforations, though not with the overall incidence (<i>p</i> = 0.284). Smoking, reported in 33.6% of patients, showed no significant association with the perforation site or overall incidence (<i>p</i> = 0.946). The combination of smoking and alcohol use favored gastric perforations, but without statistical significance (<i>p</i> = 0.157). <i>Conclusions</i>: Alcohol consumption appeared to increase the risk of ulcer perforation, while smoking did not demonstrate a statistically significant association. Although spring exhibited the highest observed incidence of peptic ulcer perforation, seasonal variation did not show a statistically significant difference overall.
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spelling doaj-art-bbb25370b9c24accbf34c713736bb64a2025-08-20T03:27:32ZengMDPI AGMedicina1010-660X1648-91442025-05-0161694510.3390/medicina61060945Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective StudyIva Krajnović0Zenon Pogorelić1Iva Perić2Marija Ćavar3Matija Borić4Department of Surgery, School of Medicine, University of Split, 21000 Split, CroatiaDepartment of Surgery, School of Medicine, University of Split, 21000 Split, CroatiaClinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, CroatiaClinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, CroatiaDepartment of Surgery, School of Medicine, University of Split, 21000 Split, Croatia<i>Background and Objectives:</i> Perforated peptic ulcers are a common surgical emergency and rank among the leading causes of acute peritonitis worldwide. Previous studies have suggested a seasonal pattern in the occurrence of symptomatic perforated peptic ulcers. With the advancement of modern medicine, including the widespread use of proton pump inhibitors, and the effects of climate change, this study aimed to assess potential seasonal variations in the incidence of peptic ulcer perforation in our region. <i>Methods:</i> This retrospective analysis included 104 adult patients (mean age: 61.5 ± 14.7 years) who underwent surgical treatment for peptic ulcer perforation between January 2021 and April 2024. Patients were analyzed by gender, age, risk factors (smoking and alcohol consumption), the location of the perforation (gastric or duodenal), and discharge outcome (survived or deceased). Additionally, cases were categorized by the month and season of the ulcer perforation. <i>Results</i>: Among the 104 patients (mean age 61.5 ± 14.7 years), 68 (65.4%) were male. Gastric and duodenal perforations were nearly equally observed (51% vs. 49%). A statistically significant difference in overall perforation rates by gender was observed (<i>p</i> = 0.009), though not between ulcer sites (<i>p</i> = 0.628 and <i>p</i> = 0.739). The highest number of perforations occurred in July (<i>n</i> = 12), while the lowest occurred in November (<i>n</i> = 4); however, no significant variation was found by month (<i>p</i> = 0.916) or season (<i>p</i> = 0.891), despite a predominance in spring. Comorbidities were present in 60% of patients. Smoking (33.6%) and alcohol use (22.1%) were common. Alcohol abuse was noted in 22.1% of patients and was significantly associated with both gastric (<i>p</i> < 0.001) and duodenal (<i>p</i> < 0.001) perforations, though not with the overall incidence (<i>p</i> = 0.284). Smoking, reported in 33.6% of patients, showed no significant association with the perforation site or overall incidence (<i>p</i> = 0.946). The combination of smoking and alcohol use favored gastric perforations, but without statistical significance (<i>p</i> = 0.157). <i>Conclusions</i>: Alcohol consumption appeared to increase the risk of ulcer perforation, while smoking did not demonstrate a statistically significant association. Although spring exhibited the highest observed incidence of peptic ulcer perforation, seasonal variation did not show a statistically significant difference overall.https://www.mdpi.com/1648-9144/61/6/945peptic ulcer perforationpeptic ulcer diseaseseasonal variationrisk factorssmokingalcohol consumption
spellingShingle Iva Krajnović
Zenon Pogorelić
Iva Perić
Marija Ćavar
Matija Borić
Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective Study
Medicina
peptic ulcer perforation
peptic ulcer disease
seasonal variation
risk factors
smoking
alcohol consumption
title Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective Study
title_full Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective Study
title_fullStr Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective Study
title_full_unstemmed Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective Study
title_short Does Seasonality Affect Peptic Ulcer Perforation? A Single-Center Retrospective Study
title_sort does seasonality affect peptic ulcer perforation a single center retrospective study
topic peptic ulcer perforation
peptic ulcer disease
seasonal variation
risk factors
smoking
alcohol consumption
url https://www.mdpi.com/1648-9144/61/6/945
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