Comparative performance of Boey, peptic ulcer perforation, and American Society of Anesthesiologists scores in predicting outcomes in patients with perforated peptic ulcer.

Background: Perforated peptic ulcer (PPU) is a surgical emergency associated with significant morbidity and mortality.Accurate and early identification of high-risk individuals is crucial in risk stratification. The primary aim of this study is tovalidate three of the most commonly used scoring systems concerning PPU: Boey, peptic ulcer perforation score (PULP),and American Society of Anesthesiologists (ASA).Patients and Methods: This is a prospective, cohort analytic study of patients presenting to a tertiary emergency hospitalrequiring surgical intervention for PPU from November 2020 to April 2021. Data included patients’ demography, clinical,laboratory, and intraoperative findings, postrepair 30-day morbidity and mortality. Receiver-operating characteristic(ROC) curve analysis was used to compute the area under the curve (AUC), cutoff point, sensitivity, and specificity foreach of the three scores.Results: This study included 52 patients with a mean age of 45.21 and male predominance. Morbidity and mortality were48.1% (n=25) and 17.3% (n=9), respectively. The AUC for ASA, Boey, and PULP for morbidity was 62.4, 69.8, and69.4%, respectively. From the measured parameters, only the intraoperative perforation size was significantly associatedwith post-PPU 30-day morbidity. Concerning mortality, the AUC for ASA, Boey, and PULP was 84.5, 86.6, and 93.5%,respectively. Age, creatinine and lactate, time from perforation to admission/surgery, and perforation size were allsignificantly associated with mortality.Conclusion: PULP is the best prognostic tool for PPU patients and can be used to evaluate both morbidity and mortality.