APPLICATION OF POMPP SCORING SYSTEM TO PREDICT POST OPERATIVE MORTALITY IN PATIENTS WITH PERFORATED PEPTIC ULCER: IS IT REALLY A PRACTICAL SCORE FOR INDIAN POPULATION?

Abstract

Background: The POMPP (Practical scoring system of mortality in patients with perforated peptic ulcer) score is a simple method which is new and easily applicable scoring system. Our aim is to predict the post operative mortality rate in patients with perforated peptic ulcer by using POMPP scoring system in Indian population. Method: A prospective study of total 100 patients of perforated peptic ulcer operated in J.L.N. Hospital, Ajmer were included in our study. Three parameters corresponding score 1 for each are included in this multivariate analysis which are age > 65 years, albumin ≤ 1.5 g/dl and BUN (Blood urea nitrogen) > 45 mg/dl. All data that may be potential predictors with respect to hospital mortality were analyzed and compared with previous studies. Results: In our study of 100 patients with M: F ratio 7.33 around 17 deaths was recorded out of which 14 were males and 3 were females. We have observed that mortality rates were signicantly affected by the parameters of POMPP scoring system with 0%, 11.76%, 35.29% and 52.95% mortality for scores 0, 1, 2 and 3 respectively. We also observed out of 17 deaths 15 deaths were seen in age group > 65 years, 11 deaths were associated with albumin < 1.5gm/l and 16 deaths were associated with blood urea nitrogen > 45mg/dl. Data analysis was done using chi square method. Conclusion: POMPP scoring system consists only age and routinely measured two simple laboratory tests (albumin and BUN), its application is easy and prediction power is satisfactory. It provides early detection of high risk peptic perforation cases; allow other supportive treatment modality apart from surgery which can decrease the mortality