Risk factors in perforated peptic ulcer disease: comparison of a new score system with the Mannheim Peritonitis Index.

OBJECTIVE

To construct a score that would accurately predict outcome for patients with perforated peptic ulcers.

DESIGN

Retrospective study.

SETTING

University Hospital.

SUBJECTS

173 patients who were operated on for perforated peptic duodenal ulcers over a 14 year period.

MAIN OUTCOME MEASURES

Results of multivariate discriminant function analysis of derived set of clinical variables known to be associated with high mortality, and comparison with the Mannheim Peritonitis Index.

RESULTS

Serious coexisting medical illness, acute renal failure, white cell count of more than 20 x 10(9)/l, and male sex were the most significant factors influencing mortality. The Hacettepe score for perforated peptic ulcer was established using these four variables. The sensitivity was 83%, the specificity 94%, and the overall predictive accuracy 93%. The corresponding figures for the Mannheim Peritonitis Index were 75%, 96%, and 94% respectively.

CONCLUSION

The Hacettepe score is useful in predicting whether a patient will survive after perforation of a peptic duodenal ulcer.