Abstract
ACCURACY OF SCORING SYSTEM IN PREDICTING PERFORATED DUODENAL ULCER MORTALITY

Nirmal Prasad Sah*, Rakesh Kumar Gupta, Vijay Shrestha, Kunal Bikram Deo and Rupesh Prasad Sah, Pawan Sapkota and Suresh Prasad Sah

ABSTRACT

Background: Bleeding, perforation, penetration, and obstruction are all possible life-threatening problems related with PUD. Perforation is found in 2-10% of patients. The Boey's scores, PULP and ASA score are currently the most widely used prognostic grading systems in patients with PPU. Materials and Methods: This is retrospective study done at B P Koirala Institute of Health Science. All patients with a perforated duodenal ulcer who had surgery were included in the study. Exclusion criteria included ruptured other organs, such as the stomach and intestines, as well as inadequate data in the medical record. The PULP score, Boey score, and ASA score were calculated as anticipated scoring systems. Results: We used the retrospective data of 74 patients. 56.8% (42) of the patients had a PULP score of 0-6 and 43.2 percent (32) of the patients had a PULP score of 7-18. According to Boey's scoring system, 10.8 percent (8), 58.1 percent (43), 25.7 percent (19), and 5.4 percent (4) of the patients were marked with 0, 1, 2, and 3 points, respectively. Boey score had highest AUC of 0.85 with cut off value>1 with accuracy 72.97%. PULP score had AUC of 0.79 with cut off values>6 with accuracy of 60.81%. ASA score had AUC of 0.765 with cut off value>3. Conclusion: The Boey risk score is a simple and precise predictor for postoperative mortality than PULP score.

Keywords: PDU, PULP score, Boey score, ASA score.


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