Role of BOEY score in association with age in predicting mortality and morbidity in peptic perforation

Paran Tudu, Pritish Roy, Partha Sarathi Naskar


Background: Peptic perforation generally requires immediate surgery. BOEY scoring system is a simple way to predict the mortality and morbidity in peptic perforation. Apart from the factors mentioned in BOYE score, patient’s age is also important. The study evaluates the accuracy of BOEY scoring system in predicting post-operative morbidity and mortality in patients operated for peptic perforation as well as inclusion of age as one of the criteria for the scoring system and thus modifying the system.

Methods: Total 103 patients were taken for this institution based prospective observational study. The 18th months study was planned as follow - initial 14 months for patient study, next 2 months for compilation of data, further 2 months for computation of statistics and final construction.

Results: Patients with BOYE score 0, 1, 2, 3 has morbidity rates as follow 7.01,19.29, 36.85 and 36.85 respectively. Whereas mortality rate was 0, 0, 9.09 and 90.91 respectively. 76.4% of patients with post-operative complications belonged to age > 45 years. All the cases of mortality were >45 years of age.

Conclusions: It is simple and can assist in risk stratification of patients with perforated peptic ulcer. It can help us to identify high-risk patients preoperatively and help in better use of limited facilities. And lastly, a modification can be done by including age (> 45 years) with the other three parameters of the BOEY scoring system.



BOEY score, Mortality, Morbidity, Peptic perforation, Age

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Chung KT, Shelat VG. Perforated peptic ulcer - an update. World J Gastrointest Surg. 2017;9(1):1-12.

Arici C, Dinckan A, Erdogan O, Bozan H, Colak T. Peptic ulcer perforation: an analysis of risk factors. World J Surg. 2018;23:45-9.

Prapasrivorakul S, Lohsiriwat D. Perforated peptic ulcer: clinical presentation, surgical outcomes, and the accuracy of the BOEY scoring system in predicting postoperative morbidity and mortality. World J Surg. 2019;33:80-5.

Lee FY, Leung KL, Lai BS, Ng SS, Dexter S, Lau WY. Predicting mortality and morbidity of patients operated on for perforated peptic ulcers. Arch Surg. 2001 Jan; 136(1):90-4.

Abdallah HA, Saleem AEA. Comparative study between Graham’s omentopexy and modified-Graham’s omentopexy in treatment of perforated duodenal ulcers. Egypt J Surg. 2018;37:485-9

KaragözAvci S, Yüceyar S, Aytaç E, Bayraktar O, Erenler I, Ustün H, et al. Comparison of classical surgery and sutureless repair with dura seal or fibrin glue for duodenal perforation in rats. Ulus Travma Acil Cerrahi Derg. 2011;17(1):9-13.

Sanabria A, Villegas MI, Morales Uribe CH. Laparoscopic repair for perforated peptic ulcer disease. Cochrane Database Syst Rev. 2013;(2): CD004778.

Gona SK, Alassan MK, Marcellin KG, Henriette KY, Adama C, Toussaint A, et al. Postoperative morbidity and mortality of perforated peptic ulcer: retrospective cohort study of risk factors among black Africans in Côte d'Ivoire. Gastroenterol Res Pract. 2016;2016: 2640730.

Thorsen K, Søreide JA, Søreide K. Scoring systems for outcome prediction in patients with perforated peptic ulcer. Scand J Trauma Resusc Emerg Med. 2013;21: 25.

Kocer B, Surmeli S, Solak C, Unal B, Bozkurt B, Yildirim O, et al. Factors affecting mortality and morbidity in patients with peptic ulcer perforation. J Gastroenterol Hepatol. 2007;22(4):565-70.

Unver M, Fırat Ö, Ünalp ÖV, Uğuz A, Gümüş T, Sezer TÖ, et al. Prognostic factors in peptic ulcer perforations: a retrospective 14-year study. Int Surg. 2015;100(5):942-8.

Byakodi KG, Harini BS, Teggimani V, Kabade N, Hiregoudar A, Vishwas MR. Factors affecting morbidity and mortality in peptic ulcer perforation. Int Surg J. 2018;5:1335-40.

Sivaram P, Sreekumar A. Preoperative factors influencing mortality and morbidity in peptic ulcer perforation. Eur J Trauma Emerg Surg. 2018;44(2): 251-7.