Nomani et al reported 2 scores for a patient with peritonitis following perforation of a duodenal ulcer. One score is based on intraoperative findings, while the second includes development of postoperative sepsis. The authors are from Khan Research Laboratories Hospital in Islamabad, Pakistan, and West Mead Hospital in Sydney, Australia.
PEDURS is an acronym for perforated duodenal risk stratification. The PEDURSS score adds an S for sepsis.
Patient assessment: intra-operative
Parameters:
(1) number of gut perforations
(2) size of largest perforation in cm
(3) volume of peritoneal fluid in mL
(4) surgical repair
(5) complications
(6) postoperative sepsis
Parameter
Finding
Points
number of perforations
1
0
>= 2
2
size of largest perforation
<= 0.5 cm
0
> 0.5 cm
2
peritoneal fluid volume
<= 1,000 mL
0
> 1,000 mL
1
surgical repair
simple
2
definitive surgery
0
complications
no
0
yes
2
postoperative sepsis
no
0
yes
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• A score >= 8 indicates high risk of 30-day morbidity or mortality.
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