الفهرس | Only 14 pages are availabe for public view |
Abstract Peptic ulcer disease (PUD) remains a common outpatient diagnosis. with the advent of proton pump inhibitors, improved hygienic conditions, and developing healthcare regimes, the prevalence of PUD has been decreased. However, the incidence of emergency surgery and the mortality associated with PUD has not decreased nearly so dramatically. Perforated peptic ulcer (PPU) represents the most frequent indication for emergency surgery for PUD. (Bertleff MJ et al., 2010) Accurate and early identification of high-risk surgical patients with perforated peptic ulcer (PPU) is important for triage and risk stratification. Therefore scoring systems have been developed to be used for prediction including (Boey, PULP, ASA, POMPP and MPI) (Anbalakan K et al., 2015) (Gupta et al., 2021) Methods: This Prospective observational study has been carried on 148 patients admitted for peptic ulcer perforation at emergency department of general surgery from start of October 2020 to the end of February 2022 at kasr Alainy emergency hospital. Four scoring systems were applied on each patient preoperatively and follow up for 30 days postoperatively detecting mortality and morbidities. Comparative analysis ofdifferent score was done. Results: Post-operative morbidity was 28 % and mortality rate was 12%. POMPP shows 78 % sensitivity and 100% specificity at cut off point >1, PULP shows 77% sensitivity and 96 % specificity at cut off point >6, Boey shows 100% sensitivity and 80% specificity at cut off point >1 and ASA shows 67% sensitivity and 94% specificity at cut off point >2. Receiver operating characteristic curve analysis showed that area under curve was 0. 99 for POMPP, 0.968 for PULP (but it is complex with more number of components), 0.936 for Boey and 0.822 for ASA. Conclusion: POMPP score is based on objective data and its components are age and routinely measured values (BUN and serum albumin). It is simple and easily applicable scoring system for predicting mortality in PPU. |