Boey评分与穿孔性消化性溃疡术后发病率和死亡率关系的研究

J. Shah, Jatin Modi
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引用次数: 0

摘要

有几个与穿孔性消化性溃疡预后不良相关的因素已被确定:诊断延误、并存内科疾病、入院时休克、白细胞增多和老年。这些因素增加了穿孔性消化性溃疡的发病率和死亡率。仔细的复苏和围手术期优化在降低与穿孔性消化性溃疡相关的发病率和死亡率方面起着重要的作用。方法对艾哈迈达巴德AMCMET医学院及研究中心附属Sheth L.G.市立总医院手术治疗的60例穿孔性消化性溃疡患者进行前瞻性研究。根据Boey评分对患者进行分类并获取其预后。目的对穿孔性溃疡手术患者的Boey评分进行评价和分析。结果本组病例的发病率为31.67%,死亡率为11.67%。随着Boey评分的升高,发病率逐渐升高:0分、1分、2分、3分分别为8.69%、36.84%、50%、62.5% (p < 0.01)。随着Boey评分的升高,死亡率逐渐升高:0分、1分、2分、3分的死亡率分别为0、5.26、30、37.5%,两者之间的关系有统计学意义(p值< 0.01)。平均住院时间为9.43±4.10 d, p值均小于0.001。死亡率和发病率曲线下面积分别为0.854和0.751。结论Boey评分方法简单,具有临床相关性,能准确预测术后发病率、死亡率和住院时间。
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A Study on Liaison between Boey Score and Perforated Peptic Ulcer in View of Postoperative Morbidity and Mortality
Introduction Several factors associated with poor outcome in perforated peptic ulcer have been identified: delay in diagnosis, coexistent medical illness, shock on admission, leukocytosis, and old age. Such factors increase morbidity and mortality in perforated peptic ulcer disease. Careful resuscitation and perioperative optimization play a significant role in reducing morbidity and mortality associated with perforated peptic ulcer disease. Methods A prospective study of 60 cases who were operated for perforated peptic ulcer was done at Sheth L.G. Municipal General Hospital affiliated with AMCMET Medical College & Research Centre, Ahmedabad. Categorization of these patients was done according to Boey score and their outcome was accessed. Objective The aim of this study was to appraise and analyze Boey score in operated cases of perforated ulcer disease. Results The morbidity and mortality rate in this study were 31.67% and 11.67%, respectively. The morbidity rate increased gradually with increase in Boey score: 8.69, 36.84, 50, and 62.5% for 0, 1, 2, and 3 score, respectively (p < 0.01). The mortality rate was increased progressively with increasing Boey score: 0, 5.26, 30, and 37.5% for 0, 1, 2, and 3 score, respectively, and this relationship was statistically significant (p-value < 0.01). The mean duration of hospital stay was 9.43 ± 4.10 days and p-value was less than 0.001. The area under curve in receiver-operating characteristic curve analysis was 0.854 and 0.751 for mortality and morbidity, respectively. Conclusion Boey score is simple, clinically relevant and can precisely predict postoperative morbidity and mortality and the length of hospital stay.
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