OBJECTIVE: The aim of the present study was to compare the ability of four clinical prediction rules to predict adverse outcome in perforated peptic ulcer (PPU): the Boey score, the American Society of Anesthesiologists (ASA) score, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, and the sepsis score. DESIGN: an observational multicenter study. PARTICIPANTS AND SETTINGS: a total of 117 patients surgically treated for PPU between 1 January 2008 and 31 December 2009 in seven gastrointestinal departments in Denmark were included. Pregnant and breastfeeding women, non-surgically treated patients, patients with malignant ulcers, and patients with perforation of other organs were excluded. PRIMARY OUTCOME MEASURE: 30-day mortality rate. STATISTICAL ANALYSIS: the ability of four clinical prediction rules to distinguish survivors from non-survivors (discrimination ability) was evaluated by the area under the receiver operating characteristic curve (AUC), positive predictive values (PPVs), negative predictive values (NPVs), and adjusted relative risks. RESULTS: Median age (range) was 70 years (25-92 years), 51% of the patients were females, and 73% of the patients had at least one co-existing disease. The 30-day mortality proportion was 17% (20/117). The AUCs: the Boey score, 0.63; the sepsis score, 0.69; the ASA score, 0.73; and the APACHE II score, 0.76. Overall, the PPVs of all four prediction rules were low and the NPVs high. CONCLUSIONS: The Boey score, the ASA score, the APACHE II score, and the sepsis score predict mortality poorly in patients with PPU.
OBJECTIVE: The aim of the present study was to compare the ability of four clinical prediction rules to predict adverse outcome in perforated peptic ulcer (PPU): the Boey score, the American Society of Anesthesiologists (ASA) score, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, and the sepsis score. DESIGN: an observational multicenter study. PARTICIPANTS AND SETTINGS: a total of 117 patients surgically treated for PPU between 1 January 2008 and 31 December 2009 in seven gastrointestinal departments in Denmark were included. Pregnant and breastfeeding women, non-surgically treated patients, patients with malignant ulcers, and patients with perforation of other organs were excluded. PRIMARY OUTCOME MEASURE: 30-day mortality rate. STATISTICAL ANALYSIS: the ability of four clinical prediction rules to distinguish survivors from non-survivors (discrimination ability) was evaluated by the area under the receiver operating characteristic curve (AUC), positive predictive values (PPVs), negative predictive values (NPVs), and adjusted relative risks. RESULTS: Median age (range) was 70 years (25-92 years), 51% of the patients were females, and 73% of the patients had at least one co-existing disease. The 30-day mortality proportion was 17% (20/117). The AUCs: the Boey score, 0.63; the sepsis score, 0.69; the ASA score, 0.73; and the APACHE II score, 0.76. Overall, the PPVs of all four prediction rules were low and the NPVs high. CONCLUSIONS: The Boey score, the ASA score, the APACHE II score, and the sepsis score predict mortality poorly in patients with PPU.
Authors: Kjetil Søreide; Kenneth Thorsen; Ewen M Harrison; Juliane Bingener; Morten H Møller; Michael Ohene-Yeboah; Jon Arne Søreide Journal: Lancet Date: 2015-09-26 Impact factor: 79.321
Authors: Tamer Saafan; Walid El Ansari; Omer Al-Yahri; Ammar Eleter; Hisham Eljohary; Rashad Alfkey; Mustafa Hajjar; Ali Toffaha; Abdelrahman El Osta Journal: Ann Med Surg (Lond) Date: 2019-05-10