An assessment of peptic ulcer perforation score: A predictor of mortality following peptic ulcer perforation from a rural tertiary care setting

Abstract

Background and Aim: Peptic ulcers (PUs) result from the increased aggressive or decreased protective elements in the stomach or duodenum, which can gradually cause mucosal damage and ulceration. The risk of death as a consequence of PU disease is highest in perforation. Therefore, early identification of patients with perforated PUs (PPUs) who are more likely to experience negative outcomes after surgery is crucial for making the right treatment decisions. Hence, this study uses the peptic ulcer perforation (PULP) score to predict mortality within 30 days of surgery and risk stratifies patients undergoing surgical therapy for PPUs. Materials and Methods: The patients presenting to a tertiary care setting with symptoms of hollow viscous perforation and intraoperative evidence suggestive of PPU were included in this prospective study between November 2016 and October 2020. After taking necessary ethical permissions from the institution, a total of 120 PPU patients were made part of this study. Results: In total, 120 patients were involved in the study including 94 men and 26 women. One hundred and ten patients were in the low-risk group, and 10 were in the high-risk group. In the postoperative period, eight patients from the high-risk group passed away, compared to two deaths in the low-risk group. Conclusion: The prognostic markers employed in the PULP score are simple to use and straightforward to be identified before surgery. The PULP score can help with the quick and accurate identification of high-risk patients, which can help with risk stratification and triaging of PPU patients.

Keywords

• peptic ulcer disease
• peptic ulcer perforation
• perforation
• systemic inflammatory response syndrome