Risk factors for mortality of esophageal perforation: A clinical experience in 32 cases

Although surgical intervention is a standard treatment of esophageal perforation, the mortality is still high. We studied 32 patients with esophageal perforation and analyzed the risk factors for mortality, including the etiology of perforation, the location of perforation, preexisting diseases, general condition, the surgical timing, the surgical and medical treatment, and the contrast media leakage. The preexisting diseases included diabetes mellitus, old cerebral vascular accident, malignancy, liver cirrhosis, and sepsis. The total mortality rate of our 32 patients was 31.3%. The mortality rate in patients with preexisting diseases was not significantly different from those without (53.8% vs. 15.8% P=0.05). However, patients with poor general condition, including preexisting disease and multiple organ injury associated with car accident, had significantly higher mortality rate than those without (62.5% vs. 0%. P<0.01). The mortality rate was not affected by the etiology or the location of perforation, the surgical timing, and contrast media leakage. We conclude that poor general condition is the major risk factor for mortality in esophageal perforation.