Accuracy of predictive score of mortality in perforated peptic ulcer to predict mortality and morbidity in patients with perforated peptic ulcer
DOI:
https://doi.org/10.18203/2349-2902.isj20252272Keywords:
Blood urea nitrogen, Duodenal ulcer perforation, H. pylori, Non-steroidal anti-inflammatory drugs , Peptic ulcer disease, POMPP scoreAbstract
Background: Peptic ulcer perforation (PPU) remains a significant surgical emergency with high morbidity and mortality, despite advancements in medical therapy. Timely and accurate prognostication is essential for optimal management. The predictive score of mortality in perforated peptic ulcer (POMPP) offers a simple, objective scoring system based on age, serum albumin and blood urea nitrogen (BUN) levels. This study aimed to assess the accuracy of the POMPP score in predicting postoperative outcomes in PPU patients.
Methods: A prospective observational study was conducted at Bir Hospital, Kathmandu, over a 12-months period from August 2021 to July 2022, including 55 patients who underwent surgery for PPU. Data were collected using a structured proforma and POMPP scores (ranging from 0 to 3) were assigned at admission. Logistic regression and ROC curve analyses were used to assess the score’s predictive performance.
Results: Patients with higher POMPP scores demonstrated significantly increased rates of both mortality and morbidity (p<0.001). The area under the ROC curve was 0.952 for mortality and 0.971 for morbidity, indicating strong predictive accuracy. A POMPP score ≥2 was associated with a 282-fold increase in mortality risk. The score showed 85.71% sensitivity, 97.92% specificity and 95.83% accuracy for predicting mortality, while for morbidity, it showed 58.33% sensitivity, 100% specificity and 92.88% accuracy.
Conclusions: The POMPP scoring system is a practical and effective tool for predicting mortality and morbidity in PPU patients. Its simplicity and reliance on readily available parameters make it particularly useful in resource-limited settings. Early identification of high-risk patients using the POMPP score can facilitate prompt intervention and potentially improve outcomes.
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References
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