Multicenter trial of a perioperative protocol to reduce mortality in critically ill patients with peptic ulcer perforation: the PULP trial
Critical Care volume 15, Article number: P287 (2011)
The aim of the present intervention study was to evaluate the effect of a multimodal and multidisciplinary perioperative care protocol on mortality in patients with peptic ulcer perforation (PPU). Sepsis is frequent and a leading cause of death in PPU patients, and morbidity and mortality is substantial [1, 2].
An externally controlled multicenter trial using historical and concurrent national controls in seven gastrointestinal departments in Denmark. Participants were 117 consecutive patients surgically treated for gastric or duodenal PPU between 1 January 2008 and 31 December 2009. The intervention was a multimodal and multidisciplinary perioperative care protocol based on the Surviving Sepsis Campaign. The main outcome measure was 30-day mortality.
Demographic characteristics were not different between the groups. The 30-day mortality proportion following PPU was 17% in the intervention group, compared with 27% in all three control groups; P = 0.005 (Figure 1). This corresponds to a relative risk (95% confidence interval) of 0.63 (0.41 to 0.97), a relative risk reduction of 37% (5 to 58) and a number needed to treat of 10 (6 to 38).
The 30-day mortality in patients with PPU was reduced by more than one-third after the implementation of a multimodal and multidisciplinary perioperative care protocol based on the Surviving Sepsis Campaign, as compared with conventional treatment.
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Moller MH, et al.: Scand J Gastroenterol. 2009, 44: 15-22.
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Møller, M.H. Multicenter trial of a perioperative protocol to reduce mortality in critically ill patients with peptic ulcer perforation: the PULP trial. Crit Care 15 (Suppl 1), P287 (2011). https://doi.org/10.1186/cc9707
- Intervention Group
- Relative Risk
- Demographic Characteristic
- Emergency Medicine
- Risk Reduction