Validation of prognostic scoring systems for predicting 30-day mortality in perforated peptic ulcer disease

Patel, Sangita; Kacheriwala, Samir; Shah, Mihir; Duttaroy, Dipesh D

doi:10.5578/turkjsurg.4211

Cited by 17 publications

(20 citation statements)

References 18 publications

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“…Several studies have been done to identify the common causes and factors influencing mortality, the most common being old age, male gender, smoking, delayed presentation, and size of the perforation. 2 3 4 …”

Section: Discussionmentioning

confidence: 99%

“…In most studies, old age, male population, nonsteroidal anti-inflammatory drug (NSAID) use, steroid use, and delayed presentation with surgery performed >24 hours after symptoms are the common predictors of mortality and morbidity. [2][3][4][5] In fact, a Danish study cohort reported that delay in surgery beyond 24 hours of presentation decreases the probability of survival by 2.4%. 6 The management of peptic ulcer perforations (PULPs) is mainly surgical.…”

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confidence: 99%

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A Comparative Study between Peptic Ulcer Perforation Score, Mannheim Peritonitis Index, ASA Score, and Jabalpur Score in Predicting the Mortality in Perforated Peptic Ulcers

et al. 2022

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Introduction Peptic ulcer disease continues to be a major public health in most developing countries despite the advances in medical management. The incidence of perforations remains high and has the highest mortality rate of any complication of ulcer disease. Risk stratification of cases will lead to better preoperative management and efficient utilization of intensive care unit resources. The purpose of the present study is to compare different existing scoring systems and identify the most accurate predictor of mortality in perforated peptic ulcer (PPU) cases. Materials and Methods This is an observational study conducted in Karnataka Institute of Medical Sciences, Hubli, India. All cases of PPU disease admitted from December 2017 to August 2019 who were treated surgically were included in the study. Demographic data were collected and peptic ulcer perforation (PULP) score, Mannheim peritonitis index (MPI), American Society of Anesthesiologists (ASA) score, and Jabalpur score (JS) were calculated for individual patient and compared. The patient was followed up during the postoperative period. Observation A total of 45 patients were included in the study with a mean age of 42.5 years. Most of the patients presented with 24 hours of the onset of symptoms. Nonsteroidal anti-inflammatory drug use was noted in 8.9% patients, and steroid use was present in 2.2% patients. Of the 45 patients, 7 deaths were reported. Between the various scoring systems, the MPI and JS were better predictors of mortality with a p-value of <0.001 and 0.007, respectively. In contrast, the PULP and ASA scores had p-value not statistically significant. However, the PULP score was a better predictor of postoperative complication with a p-value of 0.047. Conclusion Of the four scoring systems validated, the MPI and JS were better predictors of mortality in the given population. PULP score is a better predictor of postoperative complications in the present study.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A Comparative Study between Peptic Ulcer Perforation Score, Mannheim Peritonitis Index, ASA Score, and Jabalpur Score in Predicting the Mortality in Perforated Peptic Ulcers

et al. 2022

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“…~ 137 ~ group with mortality was significantly higher than that of the morbidity, and the mean age of the morbidity group was significantly higher than that of the no complication group. Sivaram P et al [3] , Bojananpu S et al [5] and several other studies have reported that patients aged 65 years or more have significantly higher rates of mortality compared with younger patients [7,8,12,13] . similar to our study and this finding is believed to be due to the increased incidence of accompanying diseases in the elderly patients.…”

Section: Observationmentioning

confidence: 94%

“…The combination of older age group, [3,5,7,8,[12][13][14] active cancer, [13,14] hyperbilirubinemia, [14] hypoalbuminemia, [13,14] elevated creatinine and delay from perforation to surgery of >24 hrs [8,11,12,14] are best predictors of mortality. Female gender, [3,15] higher BMI, [7] preoperative shock, [8,11,12] pre-operative organ failure, [5] delayed presentation, [5,8] pre-existing illness like diabetes, hypertension, COPD, ischemic heart disease, [12] definitive surgery, [11] size of perforation more ~ 135 ~ than 1 cm 2 , [3,7,15] post-operative leak & other postoperative complications [13] were found to be significant factors influencing mortality and morbidity [3,5,8] . Comorbidities such as pulmonary disease, Cardiac disease & active cancer were identified as independent risk factors for fatal long-term outcome [3,13] .…”

Section: Introductionmentioning

confidence: 99%

Study of factors to assess the mortality and morbidity in perforated peptic ulcer disease

Bodepudi¹,

Voruganti²,

Kanuru³

et al. 2022

Int. J. Surg. Sci.

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Background: Perforated peptic ulcer (PPU) is one of the most common surgical emergencies worldwide more so in India. Despite of the decreased incidence of PPU due to proton pump inhibitors, H. pylori treatment regimen and improved awareness over the last decade, the morbidity and mortality of PPU still remain considerably high. Aim: To determine the preoperative and intraoperative factors affecting post-operative morbidity & mortality in patients operated for PPU. Materials & Methods:A prospective observational study of 140 patients who were operated for PPU was done. A detailed data based on age, history of smoking & alcohol intake, concomitant comorbid diseases, shock & abnormal renal function, duration of presentation to hospital after onset of symptoms, peritoneal contamination and size of perforation was obtained. All cases were followed up for a period of 6 months postoperatively for complications. Observation: Increased morbidity & mortality was observed in patients aged above 65 years. 44% of alcoholics had morbidity and 6.6% had mortality. 51.4% patients had concomitant comorbid diseases, of which 51.4% developed post-operative complications & mortality was 8.3%. 40% of cases presenting with shock had morbidity and 4.4% had mortality. 64.3% of cases presenting to hospital after 36 hours had either morbidity or mortality. Majority of patients with purulent peritoneal contamination had either morbidity or mortality. Perforation of size greater than 0.5cm 2 showed morbidity in 44% & mortality in 16%. The overall morbidity and mortality of our study is 35% (n=49) and 5% (n=7) respectively. Conclusion: Risk factors for morbidity and mortality in PPU are elderly age, alcoholism, associated medical illness, pre-operative shock & sepsis, improper fluid resuscitation, perforation to surgery interval more than 36 hours, purulent peritoneal collection & perforation of size >0.5 cm 2 . Important post-operative factors increasing morbidity and mortality include respiratory complications, sepsis, wound infection, wound dehiscence, acute renal failure and multi organ failure.

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“…[ 3 , 9 – 11 ] If it cannot be treated timely and effectively, it may result in several complications, such as perforated peptic ulcer (PPU), gastrointestinal bleeding, gastric outlet obstruction, penetration, and even gastric cancer. [ 12 – 17 ] Of those, PPU accounts for about 2% to 10% of all patients with PUD. [ 18 ] Thus, it is very important to detect and treat PPU at early stage.…”

Section: Introductionmentioning

confidence: 99%

Psychological effect of comprehensive nursing intervention in elderly patients with perforated peptic ulcer

et al. 2020

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Background: This study aims to assess the psychological effect of comprehensive nursing intervention (CNI) in elderly patients with perforated peptic ulcer (PPU). Methods: This protocol will search all potential studies from inception to the present in electronic database sources (Cochrane Library, PUBMED, EMBASE, PsycINFO, WANGFANG, CBM, and CNKI), and other sources (such as clinical trial registry, and conference proceedings). We will not apply limitations to language and publication status. Two independent authors will scan literature, extract data, and appraise study quality. A third author will be invited to solve any disagreements between 2 authors. We will utilize RevMan 5.3 software for statistical analysis. If necessary, we will also carry out subgroup group, sensitivity analysis, and reporting bias. Results: This protocol will summarize high quality evidence to evaluate the psychological effect of CNI in elderly patients with PPU. Conclusion: The results of this study may provide evidence to determine whether CNI is effective or not on psychological effect in elderly patients with PPU. Study registration: INPLASY202080069.

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Validation of prognostic scoring systems for predicting 30-day mortality in perforated peptic ulcer disease

Abstract: Validation of prognostic scoring systems for predicting 30-day mortality in perforated peptic ulcer disease.

Cited by 17 publications

References 18 publications

A Comparative Study between Peptic Ulcer Perforation Score, Mannheim Peritonitis Index, ASA Score, and Jabalpur Score in Predicting the Mortality in Perforated Peptic Ulcers

A Comparative Study between Peptic Ulcer Perforation Score, Mannheim Peritonitis Index, ASA Score, and Jabalpur Score in Predicting the Mortality in Perforated Peptic Ulcers

Study of factors to assess the mortality and morbidity in perforated peptic ulcer disease

Psychological effect of comprehensive nursing intervention in elderly patients with perforated peptic ulcer

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