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The Peptic Ulcer Perforation (PULP Score of Moller et al

Description

Moller et al reported the Peptic Ulcer Perforation (PULP) score. It can help to identify patients with a perforated peptic ulcer who may benefit from more aggressive management. The authors are from Copenhagen University, Aarhus University Hospital, and Copenhagen University Hospital Herlev in Denmark.


 

Patient selection: perforated peptic ulcer following surgical treatement

 

Outcome: 30-day mortality

 

Parameters:

(1) age in years

(2) active malignant disease or AIDS

(3) liver cirrhosis

(4) corticosteroid therapy

(5) shock on hospital admission (systolic blood pressure < 100 mm Hg, pulse > 100 beats per minute)

(6) time from perforation to hospital admission

(7) serum creatinine in µmol/L

(8) ASA score

 

Parameter

Finding

Points

age in years

<= 65 years

0

 

> 65 years

3

active malignancy or AIDS

no

0

 

yes

1

cirrhosis

no

0

 

yes

2

corticosteroid therapy

no

0

 

yes

1

shock on admission

no

0

 

yes

1

time from perforation to admission

<= 24 hours

0

 

> 24 hours

1

serum creatinine

<= 130 µmol/L

0

 

> 130 µmol/L

2

ASA score

ASA 1

0

 

ASA 2

1

 

ASA 3

3

 

ASA 4

5

 

ASA 5

7

 

total score =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 18

• The higher the score the greater the risk of mortality.

• A score <= 7 was associated with low mortality risk (<= 25%) while a score >= 8 was associated with high risk (> 25%).

  

Parameter

Finding

0

< 1%

1 to 7

(0.5476 * ((score)^2)) - (0.381 * (points)) + 0.714

7 to 15

(-0.8896 * ((score)^2)) + (27.44 * (points)) - 124.6

>= 16

100%

 


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