Comparative performance of Boey, peptic ulcer perforation, and American Society of Anesthesiologists scores in predicting outcomes in patients with perforated peptic ulcer.
Background: Perforated peptic ulcer (PPU) is a surgical emergency associated with significant morbidity and mortality. Accurate and early identification of high-risk individuals is crucial in risk stratification. The primary aim of this study is to validate three of the most commonly used scoring systems concerning PPU: Boey, peptic ulcer perforation score (PULP), and American Society of Anesthesiologists (ASA). Patients and Methods: This is a prospective, cohort analytic study of patients presenting to a tertiary emergency hospital requiring surgical intervention for PPU from November 2020 to April 2021. Data included patients’ demography, clinical, laboratory, and intraoperative findings, postrepair 30-day morbidity and mortality. Receiver-operating characteristic (ROC) curve analysis was used to compute the area under the curve (AUC), cutoff point, sensitivity, and specificity for each of the three scores. Results: This study included 52 patients with a mean age of 45.21 and male predominance. Morbidity and mortality were 48.1% (n=25) and 17.3% (n=9), respectively. The AUC for ASA, Boey, and PULP for morbidity was 62.4, 69.8, and 69.4%, respectively. From the measured parameters, only the intraoperative perforation size was significantly associated with post-PPU 30-day morbidity. Concerning mortality, the AUC for ASA, Boey, and PULP was 84.5, 86.6, and 93.5%, respectively. Age, creatinine and lactate, time from perforation to admission/surgery, and perforation size were all significantly associated with mortality. Conclusion: PULP is the best prognostic tool for PPU patients and can be used to evaluate both morbidity and mortality.
Ghobashy, A. M., Shafik, I. A., Milad, N. M., Busada, B. J., & Ammar, A. M. (2024). Comparative performance of Boey, peptic ulcer perforation, and American Society of Anesthesiologists scores in predicting outcomes in patients with perforated peptic ulcer.. The Egyptian Journal of Surgery, 43(4), 1268-1277. doi: 10.21608/EJSUR.2024.282169.1048
MLA
Ahmed M. Ghobashy; Ismail A. Shafik; Nader M. Milad; Basim J. Busada; Ahmed M. Ammar. "Comparative performance of Boey, peptic ulcer perforation, and American Society of Anesthesiologists scores in predicting outcomes in patients with perforated peptic ulcer.", The Egyptian Journal of Surgery, 43, 4, 2024, 1268-1277. doi: 10.21608/EJSUR.2024.282169.1048
HARVARD
Ghobashy, A. M., Shafik, I. A., Milad, N. M., Busada, B. J., Ammar, A. M. (2024). 'Comparative performance of Boey, peptic ulcer perforation, and American Society of Anesthesiologists scores in predicting outcomes in patients with perforated peptic ulcer.', The Egyptian Journal of Surgery, 43(4), pp. 1268-1277. doi: 10.21608/EJSUR.2024.282169.1048
VANCOUVER
Ghobashy, A. M., Shafik, I. A., Milad, N. M., Busada, B. J., Ammar, A. M. Comparative performance of Boey, peptic ulcer perforation, and American Society of Anesthesiologists scores in predicting outcomes in patients with perforated peptic ulcer.. The Egyptian Journal of Surgery, 2024; 43(4): 1268-1277. doi: 10.21608/EJSUR.2024.282169.1048
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