A STUDY ON “PULP” SCORE AS A PREDICTOR OF MORTALITY IN CASES OF EXPLORATORY LAPAROTOMY FOR PEPTIC ULCER PERFORATION.

Background Peptic ulcer disease (PUD) affects 5–10% of adults globally, with complications such as perforation occurring in 2–10% of cases. Perforated peptic ulcer (PPU) carries high morbidity (20–50%) and mortality (up to 30%). Several scoring systems, including APACHE II and the American Society of Anesthesiologists (ASA) score, Boey, PULP have been used to predict outcomes in PUD cases .The Peptic Ulcer Perforation (PULP) score was developed to predict outcomes specifically in these cases. This study aims to validate the PULP score's predictive value and assess the impact of the perforation operation interval (POI) on patient outcomes. Methods This retrospective study, conducted between April and September 2023, analyzed 36 patients who underwent emergency surgery for PPU. Clinical data including PULP scores and perforation operation intervals were collected and outcomes assessed. Results The median patient age was 46 years, with 83% being male. Seven patients (19%) died within 30 days of surgery. Higher PULP scores (>7) were associated with increased mortality (31.5%) and morbidity (62.5%). Delays in surgery beyond 24 hours significantly reduced survival rates. Conclusion The PULP score effectively predicts mortality and morbidity in PPU cases. Its use facilitates early identification of high-risk patients, enabling timely surgical intervention and reducing complications and mortality