Global Prevalence and Clinical Outcome of Spontaneous Peptic Ulcer Perforation Related to Helicobacter pylori Infection: A Systematic Review and Meta-Analysis

Abstract

Helicobacter pylori play an important role in the pathogenesis of digestive tract diseases, including peptic ulcers. One of the severe complications of peptic ulcers is spontaneous perforation. This research aimed to analyze the incidence of spontaneous peptic ulcer perforation in patients infected with H. pylori compared to the uninfected patient. This reseach applied an analytical research with a systematic review and meta-analysis design using articles from the PubMed and Scopus databases until December 2024. The analysis was carried out using R software with the Meta and Metafor packages. The pooled prevalence of H. pylori infection in cases of spontaneous perforation of peptic ulcers was 57% (95%CI: 0.44–0.70) with the highest prevalence occurring in the Eastern Mediterranean. The results of the analysis showed that patients with spontaneous duodenal ulcer perforation, 59.0% were infected with Helicobacter pylori (95%CI: 0.29–0.83). Infected patients had a 0.48 times risk of dying postoperatively (OR = 0.48; 95%CI: 0.06–3.59) and a 0.50 times risk of experiencing postoperative complications (OR = 0.50; 95%CI: 0.02–11.07). Infected patients were treated for an average of 7.06 days shorter (95%CI: –63.00–48.89). The prevalence of H. pylori infection in patients with spontaneous peptic ulcer perforation was 57% with the highest prevalence in the Eastern Mediterranean region and the lowest in America. Patients infected with H. pylori had a lower risk of death and postoperative complications. Patients infected with H. pylori had a shorter average length of hospital stay than those not infected.