Descriptive Temporal and Seasonal Distribution in Peptic Ulcer Perforation: A Ten-Year Cohort Study

Introduction: Peptic ulcer perforation (PUP) is a critical condition in which gastric or duodenal ulcers rupture, leading to leakage of abdominal contents and life-threatening complications.While factors such as age, gender, smoking, and medication use are associated with PUP, a significant question remains unanswered: why does PUP often occur in patients without prior symptoms of peptic ulcer disease?Seasonal patterns, which may act as external triggers, have been underexplored in this context.This study aims to descriptively examine the monthly and seasonal distribution of PUP incidence over a ten-year period to better understand its occurrence and potential environmental influences.Methods: A retrospective cohort study was conducted at a Turkish tertiary hospital, gathering data on PUP cases from January 1, 2010, to December 31, 2019.To ensure a focused cohort, we excluded patients with prior gastric surgery and included only confirmed operative cases.We collected demographic (age and gender) and clinical (perforation site and seasonal trends) data.Descriptive statistics and appropriate non-parametric tests (Kruskal-Wallis) were used to analyze patient characteristics across seasons.The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines for reporting observational studies.Results: Among 287 PUP patients, who were predominantly male (83.3%) with a mean age of 42.8 years, a significant seasonal imbalance was noted.PUP cases were most frequent in summer (June to August) (34.1%) and least frequent in winter (20.6%) (p=0.012).July recorded the highest number of PUP incidents, while September recorded the fewest PUP incidents.The median age also varied significantly across seasons (p=0.034), with the youngest patients observed in autumn.Conclusion: This descriptive study found a significant seasonal imbalance in PUP case occurrence, with higher case frequency in summer and lower-case frequency in autumn and winter.These findings serve as descriptive evidence of PUP patterns in this cohort and warranting further analytical research into potential underlying mechanisms.