Alias, Juliana
(2020)
Determination of 30-day mortality in perforated peptic ulcer based on three existing scoring systems-5-year retrospective review in Hospital Sultanah Nurzahirah from January 2014 to December 2018.
Masters thesis, Universiti Sains Malaysia.
Abstract
Determination of 30-day mortality in perforated peptic ulcer based on three existing
scoring systems– 5-year retrospective review in Hospital Sultanah Nurzahirah from
January 2014 to December 2018
Background: Perforated peptic ulcer has a high morbidity and mortality. Existing scoring
systems to stratify patient at risk of mortality are American Society of Anasthesiologists
(ASA), Boey and Peptic Ulcer Perforation (PULP) scores. The aim of this study was to
determine 30-day mortality for perforated peptic ulcer patients operated in Hospital Sultanah
Nurzahirah and secondary aim was to determine the accuracy of the three scoring systems.
Methods: This is a retrospective review of patients surgically treated for perforated peptic
ulcer in a tertiary hospital in Terengganu from January 2014 to December 2018. Clinical data
and operative details were collected. Sensitivity, specificity, and area under the receiver
operating curve (AUC) were compared between each scoring systems.
Results: A total of 120 patients were included in this study of which 39 (32.5%) died within
30 days. Size of ulcer (p=0.039), site of ulcer (p=0.003), operation type (p=0.001), leakage
(p=0.005) and abdominal collection (p=0.001) were significantly associated with mortality.
Among the scoring systems, ASA has lowest predictive value for mortality (AUC 0.605)
while Boey and PULP has similar moderate predictive value for mortality with AUC of 0.686
and 0.684 respectively.
Conclusion: ASA, Boey and PULP has similar moderate accuracy to predict 30-day
mortality in PPU, with ASA has the lowest predictive value.
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