Mishra et al developed a score for evaluating patients with a perforated peptic ulcer. This can help to identify a patient who may benefit from more aggressive management. The authors are from NSCB Government Medical College in Jabalpur, India.
Patient selection: perforated peptic ulcer disease
Parameters:
(1) age in years
(2) interval between perforation and operation in hours
(3) mean systolic blood pressure in mm Hg
(4) heart rate in beats per minute
(5) serum creatinine in mg/dL
mean arterial pressure =
= ((systolic blood pressure) + (2 * (diastolic blood pressure))) / 3
Parameter
Finding
Points
age in years
< 45 years
0
45 to 54 years
2
55 to 64 years
3
65 to 74 years
5
>= 75 years
6
interval between perforation and operation
< 24 hours
25 to 72 hours
1
73 to 96 hours
97 to 120 hours
> 120 hours
4
mean systolic blood pressure
<= 49
50 to 69
70 to 109
110 to 129
130 to 159
>- 160
heart rate
<= 39
40 to 54
55 to 69
110 to 139
140 to 179
>= 180
serum creatinine
0.6 to 1.4 mg/dL
1.5 to 1.9
2.0 to 3.4
>= 3.5
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 22
• The higher the score the greater the risk for morbidity and mortality.
Total Score
Morbidity
Mortality
<= 4
14%
0%
5 to 9
48%
7%
10 to 14
71%
38%
>= 15
100%
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Specialty: Gastroenterology, Infectious Diseases, Surgery, general
