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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The Peptic Ulcer Perforation (PULP Score of Moller et al

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