A practical scoring system to predict mortality in patients with perforated peptic ulcer.
BACKGROUND
The mortality rate of perforated peptic ulcer is still high particularly for aged patients and all the existing scoring systems to predict mortality are complicated or based on history taking which is not always reliable for elderly patients. This study's aim was to develop an easy and applicable scoring system to predict mortality based on hospital admission data.


METHODS
Total 227 patients operated for perforated peptic ulcer in two centers were included. All data that may be potential predictors with respect to hospital mortality were retrospectively analyzed.


RESULTS
The mortality and morbidity rates were 10.1% and 24.2%, respectively. Multivariated analysis pointed out three parameters corresponding 1 point for each which were age >65 years, albumin ≤1,5 g/dl and BUN >45 mg/dl. Its prediction rate was high with 0,931 (95% CI, 0,890 to 0,961) value of AUC. The hospital mortality rates for none, one, two and three positive results were zero, 7.1%, 34.4% and 88.9%, respectively.


CONCLUSIONS
Because the new system consists only age and routinely measured two simple laboratory tests (albumin and BUN), its application is easy and prediction power is satisfactory. Verification of this new scoring system is required by large scale multicenter studies.
Department of General Surgery, Ankara Numune Training and Research Hospital, Ankara, 06100 Turkey.
Ebru
E
Menekse
Department of General Surgery, Faculty of Medicine, Sakarya University, Sakarya, 54000 Turkey.
Belma
B
Kocer
General Surgery Clinic, Turhal State Hospital, 60300 Tokat, Turkey.
Ramazan
R
Topcu
Department of Surgery, Faculty of Medicine, Mersin University, 33343 Mersin, Turkey.
Aydemir
A
Olmez
Department of General Surgery, Ankara Numune Training and Research Hospital, Ankara, 06100 Turkey.
Mesut
M
Tez
Department of Surgery, Faculty of Medicine, Inonu University, 44280 Malatya, Turkey.
Cuneyt
C
Kayaalp
Mortality; Peptic ulcer; Perforation; Scoring methods