Replicate and evaluate the results of peptic ulcer perforation score in our setup as a predictor of mortality following a peptic ulcer perforation

Authors

  • Jimitkumar Patel Department of General Surgery, Safal Multispeciality Hospital, Mehsana, Gujarat, India
  • Sandipkumar Chaudhari Department of General Surgery, Safal Multispeciality Hospital, Mehsana, Gujarat, India
  • Sonalben Chaudhari Department of Critical care, Safal Multispeciality Hospital, Mehsana, Gujarat, India http://orcid.org/0000-0002-8932-5359

DOI:

https://doi.org/10.18203/2320-6012.ijrms20222531

Keywords:

Peptic perforation, Score, Risk, Care, Procedure

Abstract

Background: Scores commonly employed to risk stratify perforated peptic ulcer patients include ASA (American Society of Anesthesiologists), Boey and peptic ulcer perforation score (PULP). Accurate and early identification of high-risk surgical patients with a perforated peptic ulcer is important for triage and risk stratification. The objective of the present study was to replicate and re-evaluate the results of this score in our setup, compared to the cohort study carried out in Denmark.

Method: A prospective study was conducted on 40 surgically treated patients for peptic ulcer perforation for period of one year. There was no age restriction. The predefined outcome measure was mortality within 30 days of surgical procedure for peptic ulcer perforation. Different Variables used are age, co-morbid disease, liver cirrhosis, steroids use, shock on admission, the time lapse between perforation and admission, serum creatinine, as well as ASA score 2 to 5.

Results: A total of 40 patients were studied in a single hospital over one year. Nearly 12.5% (5 patients) died within 30 days of surgery. Out of total deaths, most deaths occurred in patients with a PULP score of more than 7, and the risk of mortality increases with an increase in the PULP score. So, the risk stratification is classified into low risk and high risk according to pulp score.

Conclusions: The PULP score can be used to predict 30-day mortality in patients with peptic ulcer perforation who have undergone surgery almost accurately and thus assist in risk stratification and triage. This study hence replicates the cohort study in Denmark in our setup.

Author Biographies

Jimitkumar Patel, Department of General Surgery, Safal Multispeciality Hospital, Mehsana, Gujarat, India

Consultant Physician, Department of Critical Care & Respiratory Medicine.

Sandipkumar Chaudhari, Department of General Surgery, Safal Multispeciality Hospital, Mehsana, Gujarat, India

General Surgery

References

Testini M, Portincasa P, Piccinni G, Lissidini G, Pellegrini F, Greco L. Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer. World J Gastroenterol. 2003;9:2338-40.

Noguiera C, Silva AS, Santos JN. Perforated peptic ulcer: main factors of morbidity and mortality. World J Surg. 2003;27(7): 782-7.

Christensen S, Riis A, Nørgaard M, Thomsen RW, Tønnesen EM, Larsson A, Sørensen HT. Perforated peptic ulcer: use of pre-admission oral glucocorticoids and 30-day mortality. Aliment Pharmacol Ther. 2006;23(1):45-52.

Behrman SW. Management of complicated peptic ulcer disease. Arch Surg. 2005;140:201-8.

Ng EK, Chung SC, Sung JJ. High prevalence of Helicobacter pylori infection in duodenal ulcer perforations not caused by non-steroidal anti-inflammatory drugs. Br J Surg. 1996;83:1779-81.

Saafan T, El Ansari W, Al-Yahri O. Assessment of PULP score in predicting 30-day perforated duodenal ulcer morbidity, and comparison of its performance with Boey and ASA, a retrospective study. Ann Med Surg Lond. 2019;10:23-8.

Møller MH, Engebjerg MC, Adamsen S, Bendix J, Thomsen RW. The Peptic Ulcer Perforation (PULP) score: a predictor of mortality following peptic ulcer perforation. A cohort study. Acta Anaesthesiol Scand. 2012;56:655-62.

Kim JM, Jeong SH, Lee YJ. Analysis of risk factors for postoperative morbidity in perforated peptic ulcer. J Gastric Cancer. 2012;12:26-35.

Kate V, Ananthakrishnan N, Badrinath S. Effect of Helicobacter pylori eradication on the ulcer recurrence rate after simple closure of perforated duodenal ulcer: retrospective and prospective randomized controlled studies. Br J Surg. 2001;88:1054-8.

Ng EK, Lam YH, Sung JJ. Eradication of Helicobacter pylori prevents recurrence of ulcer after simple closure of duodenal ulcer perforation: randomized controlled trial. Ann Surg. 2000;231:153-8.

Lee FY, Leung KL, Lai BS. Predicting mortality and morbidity of patients operated on for perforated peptic ulcers. Arch Surg. 2001;136:90-4.

Rix TE, Bates T. Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery. World J Emerg Surg. 2007;2:16.

Downloads

Published

2022-09-27

How to Cite

Patel, J., Chaudhari, S., & Chaudhari, S. (2022). Replicate and evaluate the results of peptic ulcer perforation score in our setup as a predictor of mortality following a peptic ulcer perforation. International Journal of Research in Medical Sciences, 10(10), 2257–2260. https://doi.org/10.18203/2320-6012.ijrms20222531

Issue

Section

Original Research Articles