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World Journal of Surgery

Published in:

01-01-2009

Perforated Peptic Ulcer: Clinical Presentation, Surgical Outcomes, and the Accuracy of the Boey Scoring System in Predicting Postoperative Morbidity and Mortality

Authors: Varut Lohsiriwat, Siriluck Prapasrivorakul, Darin Lohsiriwat

Published in: World Journal of Surgery | Issue 1/2009

Abstract

Background

The purposes of this study were to determine clinical presentations and surgical outcomes of perforated peptic ulcer (PPU), and to evaluate the accuracy of the Boey scoring system in predicting mortality and morbidity.

Methods

We carried out a retrospective study of patients undergoing emergency surgery for PPU between 2001 and 2006 in a university hospital. Clinical presentations and surgical outcomes were analyzed. Adjusted odds ratio (OR) of each Boey score on morbidity and mortality rate was compared with zero risk score. Receiver-operating characteristic curve analysis was used to compare the predictive ability between Boey score, American Society of Anesthesiologists (ASA) classification, and Mannheim Peritonitis Index (MPI).

Results

The study included 152 patients with average age of 52 years (range: 15–88 years), and 78% were male. The most common site of PPU was the prepyloric region (74%). Primary closure and omental graft was the most common procedure performed. Overall mortality rate was 9% and the complication rate was 30%. The mortality rate increased progressively with increasing numbers of the Boey score: 1%, 8% (OR = 2.4), 33% (OR = 3.5), and 38% (OR = 7.7) for 0, 1, 2, and 3 scores, respectively (p < 0.001). The morbidity rates for 0, 1, 2, and 3 Boey scores were 11%, 47% (OR = 2.9), 75% (OR = 4.3), and 77% (OR = 4.9), respectively (p < 0.001). Boey score and ASA classification appeared to be better than MPI for predicting the poor surgical outcomes.

Conclusions

Perforated peptic ulcer is associated with high rates of mortality and morbidity. The Boey risk score serves as a simple and precise predictor for postoperative mortality and morbidity.

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Title: Perforated Peptic Ulcer: Clinical Presentation, Surgical Outcomes, and the Accuracy of the Boey Scoring System in Predicting Postoperative Morbidity and Mortality
Authors: Varut Lohsiriwat
Siriluck Prapasrivorakul
Darin Lohsiriwat
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 1/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-008-9796-1

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Perforated Peptic Ulcer: Clinical Presentation, Surgical Outcomes, and the Accuracy of the Boey Scoring System in Predicting Postoperative Morbidity and Mortality

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

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Abstract

Background

Methods

Results

Conclusions

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