Researchers have found in a new study that C-reactive protein (CRP) and the albumin/creatinine ratio are readily available biomarkers that can help in perioperative risk assessment for patients undergoing surgery for perforated peptic ulcer. Reliance on defect size alone may be inadequate for prognostication when systemic inflammatory markers are considered.Peptic ulcer perforation remains a life-threatening surgical emergency associated with considerable postoperative mortality. Identifying reliable preoperative predictors is crucial for risk stratification. In this study, we aimed to investigate the predictive value of C-reactive protein, albumin/creatinine ratio, defect size, and selected demographic variables for 30-day mortality following surgical treatment of peptic ulcer perforation. A retrospective analysis was conducted on 154 patients who underwent emergency surgery for peptic ulcer perforation. The association between 30-day postoperative mortality and C-reactive protein, albumin/creatinine ratio, defect size, as well as selected demographic variables was evaluated. Univariate and multivariate logistic regression analyses were performed. ROC analysis was used to determine optimal cutoff values. p < 0.05 was considered statistically significant. Results: The mean age of the patients was 56. 102 (66.2%) of the patients were male. The 30-day mortality rate in the study cohort was 16.9%. A CRP level greater than 88 mg/L (p < 0,001) and an albumin/creatinine ratio below 3.37 (p < 0.001) were identified as independent predictors of mortality. While a defect size greater than 5 mm was significant in univariate analysis, it did not retain significance in the multivariate model.CRP and the albumin/creatinine ratio are easily accessible biomarkers that may support perioperative risk stratification in patients undergoing surgery for perforated peptic ulcer. Defect size alone may be insufficient to reliably reflect prognosis when systemic inflammatory markers are taken into account.Reference:Canlıkarakaya, F., Ocaklı, S., Doğan, İ. et al. The role of biomarkers in predicting mortality in peptic ulcer perforation. BMC Surg (2026). https://doi.org/10.1186/s12893-026-03537-4Keywords:CRP, ACR, Aid, Risk, Stratification, Perforated, Peptic Ulcer Surgery, Study, Canlıkarakaya, F., Ocaklı, S., Doğan