Perforated peptic ulcer disease is an emergent non-traumatic acute abdomen that ends with mortality if not intervened early. It is one of the three most common causes of acute surgical abdomen in our local context. However, there is a shortage of post-operative treatment outcome data. Therefore, this study aimed to identify the post-operative treatment outcome and associated factors among patients with perforated peptic ulcer disease treated at tertiary hospitals.

A prospective Observational study was conducted at four different public hospitals. The data were collected using a structured tool and filled into a Kobo toolbox by data collectors. The collected data were exported to the statistical package for Social Science (SPSS) version 23 for analysis.

One hundred seventy patients with perforated peptic ulcer disease participated in the study. The proportion of H pylori-infected patient was 30.6% and post-operative complications rate was 32.4%. The overall in-hospital mortality rate was 9.4% with 95% CI (5.5% - 14.8%). Increasing age (AOR=1.06, 95% CI: 1.001, 1.12), delayed presentation (AOR= 1.02 95% CI: 1.00, 1.04), Longer operative time (AOR=4.92, 95% CI: 1.48, 16.37), Intra-abdominal collection (AOR=1.84, 95%CI: 1.08, 3.17) and ICU admission (AOR= 6.4 95% CI: 1.35, 30.35) were factors significantly associated with mortality.

The incidence of postoperative mortality among perforated PUD patients was relatively high which had a positive association with delayed patient presentation to hospitals, longer operative time, amount of intra-abdominal collection, and admission to ICU. However, no significant association was found among known causal risk factors for PUD.