IDENTIFICATION OF A NOVEL PROGNOSTIC SCORING SYSTEM AS A POSITIVE PREDICTOR OF MORBIDITY AND MORTALITY IN THE PERFORATED DUODENAL ULCER PATIENTS

Objective: We aimed at the prognostic factors identification in the patients of perforated duodenal ulcer and also aimed at the assessment and suggestion of novel scoring system. Methods: Our research was completed in the timeframe of April, 2016 to October, 2016 at Services Hospital, Lahore. We completed this research in two different phases with different timeframes on the perforated duodenal ulcer patients who were identified in the timeframe of thirty days with the predicting factors prognosis. Severity level was used for the scoring system of the predictive factor with the help of modern scoring system and Univariate analysis was performed through Chi-square testing. Forward step by step progression was used for the multivariate analysis. We also calculated the new scoring system accuracy with the help of curve analysis and validated it in the last study phase. Results: Poor prognosis predictors were largest perforation size above (0.5 cm), multiple gut perforations, peritoneal fluid amount above (1000 ml), complications development, simple closure, autumn/ winter seasonal presentation and postoperative systemic septicemia. Thirty-two cases presented an overall mortality rate of thirty days (32.3%) and 21 cases of morbidity (21.2%). Poor prognosis cases were observed with higher scores with significant P-value of (0.001). Similarly, grave prognosis cases were also observed with great scores with significant P-value as (0.001). An overall sensitivity and specificity was respectively 85.12% and 80.67%, which can be compared with the other systems of scoring. Conclusion: New scoring system is considered as a helpful and useful instrument for the prediction of thirty days prognosis for the patients of acid peptic disease and perforated duodenal ulcers. Keywords: Ulcer, Duodenal Perforation, Peptic Acid, Prognosis, Mortality and Morbidity