Validation of Pre-Operative BOEY’s Score for Post-Operative Outcomes of Duodenal Ulcer Perforation: A Study at a Tertiary Care Hospital in Khyber Pukhtunkhwa

Authors

  • Sonia Ejaz Department of General Surgery, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Khalid Abbas Department of General Surgery, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Sara Rahman Department of General Surgery, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Muhammad Tayyeb Department of General Surgery, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Suliman Shah Department of General Surgery, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Mazhar Khalil Department of General Surgery, Khyber Teaching Hospital, Peshawar, KP, Pakistan.
  • Sikandar Zahoor Department of General Surgery, Lady Reading Hospital, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i6.1647

Keywords:

Peptic Ulcer Perforation, Boey’s Score, Morbidity, Mortality

Abstract

Introduction: The lifetime prevalence of peptic ulcer disease, once estimated to be 5-10%, has steadily declined over the past three decades. This study will not only report recent data for local and international practitioners but also serve as a validation of Boey’s score in our population. Objective: To assess the frequency of in-hospital morbidity and mortality following peptic ulcer perforation repair based on preoperative Boey’s score. Methods and Materials: A Descriptive Case series was conducted in Surgical B unit, Lady Reading Hospital, Peshawar, from January 2022 to December 2024. We conducted this study on 71 patients aged between 18 and 60 years, of both genders, with peptic ulcer perforation. The frequency of morbidity and mortality was assessed based on Boey’s score. Results: The mean age of the patients was 38.49 ± 11.59 years. The frequency of morbidity in patients with Boey’s score 0 was 1 (1.9%), with score 1 was 2 (50%), with score 2 was 5 (83.2%), and with score 3 was 8 (88.9%). The frequency of mortality in patients with Boey’s score 0 was 1 (1.9%), with score 1 was 1 (25%), with score 2 was 2 (33.3%), and score 3 was 4 (44.4%). Conclusion: From our study we conclude that based on preoperative Boey’s score 0, 1, 2 and 3 the frequency of morbidity was 1 (1.9%), 2 (50%), 5 (83.2%) and 8 (88.9%) respectively while mortality was 1 (1.9%), 1 (25%), 2 (33.3%) and 4 (44.4%) respectively following peptic ulcer perforation.

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References

Lanas, A., & Chan, F. K. (2017). Peptic ulcer disease. The Lancet, 390(10094), 613-624.

https://doi.org/10.1016/s0140-6736(16)32404-7

Gona, S. K., Alassan, M. K., Marcellin, K. G., Henriette, K. Y., Adama, C., Toussaint, A., Manuela, E. A., Sylvain, S. G., Anthony, A. A., & Francis, E. S. (2016). Postoperative morbidity and mortality of perforated peptic ulcer: Retrospective cohort study of risk factors among Black Africans in Cote d’Ivoire. Gastroenterology Research and Practice, 2016, 1-7.

https://doi.org/10.1155/2016/2640730

Bojanapu, S., Malani, R. A., Ray, S., Mangla, V., Mehta, N., & Nundy, S. (2020). Duodenal perforation: Outcomes after surgical management at a tertiary care centre—A retrospective cross-sectional study. Surgery Research and Practice, 2020, 1-8.

https://doi.org/10.1155/2020/8392716

Chung, K. T., & Shelat, V. G. (2017). Perforated peptic ulcer - an update. World Journal of Gastrointestinal Surgery, 9(1), 1.

https://doi.org/10.4240/wjgs.v9.i1.1

Yan, X., Kuang, H., Zhu, Z., Wang, H., Yang, J., Duan, X., Bian, H., Zheng, N., & Chen, X. (2018). Gastroduodenal perforation in the pediatric population: A retrospective analysis of 20 cases. Pediatric Surgery International, 35(4), 473-477.

https://doi.org/10.1007/s00383-018-4420-4

Mirabella, A., Fiorentini, T., Tutino, R., Falco, N., Fontana, T., De Marco, P., Gulotta, E., Gulotta, L., Licari, L., Salamone, G., Melfa, I., Scerrino, G., Lupo, M., Speciale, A., & Cocorullo, G. (2018). Laparoscopy is an available alternative to open surgery in the treatment of perforated peptic ulcers: A retrospective multicenter study. BMC Surgery, 18(1).

https://doi.org/10.1186/s12893-018-0413-4

Saafan, T., El Ansari, W., Al-Yahri, O., Eleter, A., Eljohary, H., Alfkey, R., Hajjar, M., Toffaha, A., & El Osta, A. (2019). Assessment of PULP score in predicting 30-day perforated duodenal ulcer morbidity, and comparison of its performance with Boey and ASA, a retrospective study. Annals of Medicine and Surgery, 42, 23-28.

https://doi.org/10.1016/j.amsu.2019.05.001

Patel, S., Kalra, D., Kacheriwala, S., Shah, M., & Duttaroy, D. (2019). Validation of prognostic scoring systems for predicting 30-day mortality in perforated peptic ulcer disease. Turkish Journal of Surgery, 35(4), 252-258.

https://doi.org/10.5578/turkjsurg.4211

Hernandez, M. C., Thorn, M. J., Kong, V. Y., Aho, J. M., Jenkins, D. H., Bruce, J. L., Laing, G. L., Zielinski, M. D., & Clarke, D. L. (2018). Validation of the AAST EGS grading system for perforated peptic ulcer disease. Surgery, 164(4), 738-745.

https://doi.org/10.1016/j.surg.2018.05.061

Sazhin, A., Ivakhov, G., Stradymov, E., Petukhov, V., & Titkova, S. (2020). The modified Boey score (mBoey) for outcome prediction in patients with perforated peptic ulcer complicated by diffuse peritonitis: A retrospective study.

https://doi.org/10.21203/rs.3.rs-28623/v1

Koirala, R., Pant, P., Acharya, N., & Rajbhandary, A. (2019). Use of Boey’s score in peptic perforation disease in the Nepalese population: A prospective observational study. Journal of Society of Surgeons of Nepal, 22(1), 2-6.

https://doi.org/10.3126/jssn.v22i1.28708

Agarwal, A., Jain, S., Meena, L., Jain, S. A., & Agarwal, L. (2015). Validation of Boey’s score in predicting morbidity and mortality in peptic perforation peritonitis in northwestern India. Tropical Gastroenterology, 36(4), 256-260.

https://doi.org/10.7869/tg.300

Lohsiriwat, V., Prapasrivorakul, S., & Lohsiriwat, D. (2008). Perforated peptic ulcer: Clinical presentation, surgical outcomes, and the accuracy of the Boey scoring system in predicting postoperative morbidity and mortality. World Journal of Surgery, 33(1), 80-85.

https://doi.org/10.1007/s00268-008-9796-1

Thorsen, K., Søreide, J. A., & Søreide, K. (2013). Scoring systems for outcome prediction in patients with perforated peptic ulcer. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 21(1).

https://doi.org/10.1186/1757-7241-21-25

Di Saverio, S., Bassi, M., Smerieri, N., Masetti, M., Ferrara, F., Fabbri, C., Ansaloni, L., Ghersi, S., Serenari, M., Coccolini, F., Naidoo, N., Sartelli, M., Tugnoli, G., Catena, F., Cennamo, V., & Jovine, E. (2014). Diagnosis and treatment of perforated or bleeding peptic ulcers: 2013 WSES position paper. World Journal of Emergency Surgery, 9(1).

https://doi.org/10.1186/1749-7922-9-45

Dhruba, S. N, & Sah, D. (2019). Boey Score in Predicting Outcome in Perforated Peptic Ulcer from Tertiary Referral Center of Nepal. ARC Journal of Surgery, 5(1).

https://doi.org/10.20431/2455-572x.0501002

MØLLER, M. H., ENGEBJERG, M. C., ADAMSEN, S., BENDIX, J., & THOMSEN, R. W. (2011). The Peptic Ulcer Perforation (PULP) score: a predictor of mortality following peptic ulcer perforation. A cohort study. Acta Anaesthesiologica Scandinavica, 56(5), 655–662.

https://doi.org/10.1111/j.1399-6576.2011.02609.x

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Published

2025-06-20

How to Cite

Ejaz, S., Abbas, K., Rahman, S., Tayyeb, M., Shah, S., Khalil, M., & Zahoor, S. (2025). Validation of Pre-Operative BOEY’s Score for Post-Operative Outcomes of Duodenal Ulcer Perforation: A Study at a Tertiary Care Hospital in Khyber Pukhtunkhwa. Indus Journal of Bioscience Research, 3(6), 248-251. https://doi.org/10.70749/ijbr.v3i6.1647