Comparison of POMPP Scoring System with PULP Score, Boey Score, and ASA Scoring Systems to Predict Mortality in Peptic Perforation

Abstract

Perforated peptic ulcer represents the most frequent indication for emergency surgery for peptic ulcer disease. The mortality from perforated peptic ulcer remains up to 27%. We compare predictive score of mortality in perforated peptic ulcer (POMPP) scoring system with peptic ulcer perforation (PULP) score, Boey score, and American Society of Anesthesiologists (ASA) score to predict mortality. Hundred consecutive patients were operated for peptic perforation from May 2018 to May 2019 in our institute. For prediction of mortality, scoring was done by POMPP score, PULP score, Boey score, and ASA score. Comparative analysis of different score was done. Mean age was 40.7 years and male to female ratio was 32.3:1. Post-operative morbidity was 27% and mortality rate was 11%. Of the 10 patients of high POMPP score, 8 patients died (p value 0.000001) with accuracy of 80%. Receiver operating characteristic curve analysis showed that area under curve was 0.964 for POMPP score, 0.980 for PULP score, 0.960 for Boey score, and 0.906 for ASA score. The specificity of Boey score, POMPP score, and PULP score was 88.7%, 97.7%, and 100% respectively. Boey score had accuracy of 44.4% and PULP score had 100% accuracy in predicting mortality but it is complex with more number of components. POMPP score is based on objective data and its components are age and routinely measured values (blood urea nitrogen and serum albumin). It is simple and easily applicable scoring system for predicting mortality in peptic perforation peritonitis patients with accuracy of 80%.