PULP SCORE AS A PREDICTOR OF MORBIDITY AND MORTALITY IN PATIENTS WITH PERFORATED PEPTIC ULCER AT A SECONDARY CARE HOSPITAL carmelomenesesr@gmail.com

 

PULP SCORE AS A PREDICTOR OF MORBIDITY AND MORTALITY IN PATIENTS WITH PERFORATED PEPTIC ULCER AT A SECONDARY CARE HOSPITAL

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Mexico

Poster Exhibition only

Peptic ulcer disease affects million people annually, with a global prevalence of 5–10%. 10%-20% develops complications, notably perforation, which occurs in 2–10% of patients and is a major cause of death associated with acid peptic disease. Various prognostic scores have been proposed to predict 30-day postoperative outcomes. This study evaluates the predictive performance of the PULP Score compared with the Boey and ASA scores.

A retrospective, observational, case-control study was conducted in a secondary care hospital. The PULP Score was applied to patients with an intraoperative diagnosis of perforated peptic ulcer. Boey and ASA scores were also recorded. All patients were followed for 30 days to document complications and mortality. Data were compiled in Excel and analyzed with SPSS, calculating ROC curves for each scoring system.

39 patients were included (71.8% male). Smoking was reported in 48.7%, alcohol consumption in 53.8%, and NSAID use in 25.6%. Comorbidities were present in 51.3%, most commonly type 2 diabetes (25.6%). Laparotomy was performed in 89.7% of cases, predominantly using the Celan Jones technique (82.1%). The complication rate was 15.4%. Risk factors for mortality included male sex, age > 65 years, delayed surgery, shock, comorbidities, and creatinine > 1.47 mg/dL. The PULP Score showed superior prognostic accuracy (AUC 0.8571, p = 0.0206) compared with Boey (AUC 0.7000) and ASA (AUC 0.6857).

PULP Score is an efficient, accessible, and sensitive tool for predicting mortality in perforated peptic ulcer. Its application may improve risk stratification and guide clinical decision-making, even in resource-limited secondary care settings.