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

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