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Prospective study and applicability of pulp score to predict mortality and morbidity following peptic ulcer

Sheetal A Murchite, Thakut Gowtham, Aniket Patil, Vaishali Vinayak Gaikwad, Vishwas Gowda.




Abstract
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Introduction: This study aims to predict the mortality and morbidity of patients with peptic ulcer perforation by PULP score. This scoring system has been chosen as the variables required (age, comorbidities, concurrent steroid use, shock on admission, serum creatinine levels, time from perforation to admission, and ASA scores) can be easily calculated with available investigations in hospitals. This study was done in the department of general surgery Dr D. Y. Patil medical college, hospital, and research institute. Fifty patients admitted with peptic ulcer perforation were included in this study after getting their informed consent. Scores of 0-7 were associated with low risk, and 8-18 were associated with a high risk of mortality preoperatively.
Result 50 patients were studied in the last two years i.e. November 2018 to October 2020, 43 (86%) were males, and the remaining 7 (14%) were females. 9 (18%) experienced death, and 41 (82%) survived. 20 (40%) were morbid, and the remaining 30 (60%) were not morbid. Eight patients of high risk died, and 20 patients of low and high risk had morbidity. A comparison of this study with M. H. Moller et al., the study showed that the results are almost similar, except for slightly increased mortality and morbidity rates observed in patients with a score of 8-18.
Conclusion PULP score is easy to calculate risk stratification of a patient with a perforated peptic ulcer so that patients with higher scores can receive greater intensive care.

Key words: Perforated peptic ulcer, PULP score, perforation






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