Abstract
BACKGROUND: Peptic ulcer perforation is a potentially life-threatening complication of peptic ulcer disease. Several scoring systems have been developed to predict outcomes in these patients. The red cell distribution width-to-albumin ratio (RAR) has shown promise as a prognostic marker in various conditions, yet its role in peptic ulcer perforation remains unclear. This study aimed to evaluate the predictive value of RAR in patients with peptic ulcer perforation. METHODS: This retrospective study was conducted between 2016 and 2024 on patients who underwent surgery for peptic ulcer perforation. Patient demographics, clinical features, laboratory values, and surgical outcomes were analyzed. The main outcomes were major postoperative complications and 30-day mortality. Multivariate regression analysis was used to identify independent predictors of these outcomes. The ability of RAR to predict outcomes was also assessed. RESULTS: The study included 187 patients with a median age of 49.7 years, of whom 78.6% were males. Major complications occurred in 18.1% of the patients and the 30-day mortality rate was 9.6%. Multivariate analysis identified age, surgical delay, elevated C-reactive protein and RAR as independent predictors of major complications. For 30-day mortality, only age and RAR remained significant in the multivariate model. Receiver operating characteristic curve analysis showed that RAR had high diagnostic accuracy for predicting both major complications (AUC = 0.883) and mortality (AUC = 0.944). CONCLUSION: With its high sensitivity and specificity for predicting major complications and mortality in patients with peptic ulcer perforation, RAR has significant potential as a prognostic marker in conjunction with traditional risk factors in clinical practice.