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Jabalpur Prognostic Scoring System: Revisited After 2 Decades

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Abstract

Introduction

Jabalpur Prognostic Scoring System (JPSS), a simple scoring system, was developed to prognosticate the outcome for perforated peptic ulcer (PPU) in 2003 when there was no dedicated Surgical Intensive Care Unit (SICU) in the authors’ institution. It is based on six easily available parameters, namely patient’s age, perforation-operation interval, mean systolic blood pressure, heart rate, serum creatinine and the presence of comorbid illness. Its accuracy has since been validated by many authors and has been found to be comparable with other prognostic scoring systems. Availability of SICU in the last one decade has prompted us to re-assess the utility and validity of the JPSS in the current age.

Methods

Prospectively collected JPSS data of 214 consecutive patients (prospective group, PG), who underwent Graham’s patch omentopexy closure of a PPU, was compared with the JPSS cohort of 2003 (original group, OG). Sensitivity and specificity were calculated, and accuracy was measured using receiver operating characteristic curve analysis.

Results

The PG had 214 patients, while the OG had 140 patients. PG had significantly more women patients, and a shorter hospital stay, otherwise, both groups were comparable. Postoperative mortality and morbidity, both overall and in different JPSS classes were statistically similar. Overall accuracy of JPSS in PG was 77% with a cutoff of 11 as compared to the OG where these values were 92% and 9 respectively.

Conclusion

JPSS continues to be effective and accurate in predicting the outcome of patients with PPU in the current age.

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References

  1. Sharma D (2002) Scoring systems for intra-abdominal sepsis: the science of predicting risks. Indian J Surg 64(2):125–147

    Google Scholar 

  2. Nag DS (2015) Assessing the risk: scoring systems for outcome prediction in emergency laparotomies. Biomedicine (Taipei) 5(4):20. https://doi.org/10.7603/s40681-015-0020-y

    Article  PubMed  Google Scholar 

  3. Jhobta RS, Attri AK, Kaushik R, Sharma R, Jhobta A (2006) Spectrum of perforation peritonitis in India--review of 504 consecutive cases. World J Emerg Surg 5(1):26. https://doi.org/10.1186/1749-7922-1-26

    Article  Google Scholar 

  4. Bali RS, Verma S, Agarwal PN, Singh R, Talwar N (2014) Perforation peritonitis and the developing world. ISRN Surg 2(2014):105492. https://doi.org/10.1155/2014/105492

    Article  Google Scholar 

  5. Hameed T, Kumar A, Sahni S, Bhatia R, Vidhyarthy AK (2020) Emerging spectrum of perforation peritonitis in developing world. Front Surg 15(7):50. https://doi.org/10.3389/fsurg.2020.00050

    Article  Google Scholar 

  6. Bohnen JM, Mustard RA, Oxholm SE, Schouten BD (1988) APACHE II score and abdominal sepsis. Prospective Study. Arch Surg. 123(2):225–229. https://doi.org/10.1001/archsurg.1988.01400260113014

    Article  CAS  PubMed  Google Scholar 

  7. Billing A, Fröhlich D, Schildberg FW (1994) Prediction of outcome using the Mannheim peritonitis index in 2003 patients. Peritonitis Study Group. Br J Surg. 81(2):209–213. https://doi.org/10.1002/bjs.1800810217

    Article  CAS  Google Scholar 

  8. Mishra A, Sharma D, Raina VK (2003) A simplified prognostic scoring system for peptic ulcer perforation in developing countries. Indian J Gastroenterol 22(2):49–53

    PubMed  Google Scholar 

  9. Singh S, Sharma S, Hans S, Singh N, Gupta A, Neki NS, Shergill GS (2017) Prognostication of perforation peritonitis cases using Jabalpur peritonitis index. Int J Curr Res Med Sci 3(3):22–29. https://doi.org/10.22192/ijcrms.2017.03.03.004

    Article  Google Scholar 

  10. Subangi KG, Aravind N (2018) A comparative study of pulp scoring vs Jabalpur prognostic scoring in predicting outcome in patients with peptic ulcer Perforation. IOSR-JDMS 17(2):45–53. https://doi.org/10.9790/0853-1702144553

    Article  Google Scholar 

  11. Sathish KG (2018) Jabalpur Scoring to predict morbidity and mortality in peptic ulcer perforation. Int J Sci Eng Res 9(9):1295–1309

    Google Scholar 

  12. Agarwal N, Gupta A, Jain BK, Saran RN (2018) Omental patch repair for duodenal ulcer perforation- analysis of factors affecting outcome: a prospective study. Gastroenterol Pancreatol Liver Disord 6(2):1–6. https://doi.org/10.15226/2374-815X/6/2/001125

    Article  Google Scholar 

  13. Prakash GV, Vijay Kumar Reddy B, Srihari Rao B, Srikanth Reddy C, Raghuram G, Ajay Babu K et al (2019) Comparison of the efficacy of Jabalpur prognostic scoring system with Mannheims peritonitis index in evaluation of prognosis in patients with perforation peritonitis. Int Surg J 6(7):2390–2394. https://doi.org/10.18203/2349-2902.isj20192961

    Article  Google Scholar 

  14. Dharmendra BL, Bagalkot VS (2021) Role of Jabalpur score in predicting mortality among patients with peritonitis secondary to peptic ulcer perforation. Trop Gastroenterol 42(3):122–125. https://doi.org/10.7869/tg.638

    Article  Google Scholar 

  15. Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13(10):818–829

    Article  CAS  PubMed  Google Scholar 

  16. Thorsen K, Søreide JA, Søreide K (2013) Scoring systems for outcome prediction in patients with perforated peptic ulcer. Scand J Trauma Resusc Emerg Med 10(21):25. https://doi.org/10.1186/1757-7241-21-25

    Article  Google Scholar 

  17. Koskensalo S, Leppäniemi A (2010) Perforated duodenal ulcer: has anything changed? Eur J Trauma Emerg Surg 36(2):145–150. https://doi.org/10.1007/s00068-010-9128-7

    Article  PubMed  Google Scholar 

  18. Lee MJ, Coe PO, O'Donoghue R, Peirson M, Saha A (2020) Variation in descriptors of patient characteristics in randomized clinical trials of peptic ulcer repair: a systematic review. Br J Surg 107(12):1570–1579. https://doi.org/10.1002/bjs.11771

    Article  CAS  PubMed  Google Scholar 

  19. Polderman KH, Girbes AR, Thijs LG, Strack van Schijndel RJ (2001) Accuracy and reliability of APACHE II scoring in two intensive care units. Problems and pitfalls in the use of APACHE II and suggestions for improvement. Anaesthesia 56(1):47–50. https://doi.org/10.1046/j.1365-2044.2001.01763.x

    Article  CAS  PubMed  Google Scholar 

  20. Nally DM, Lonergan PE, O'Connell EP, McNamara DA (2022) SURGical Improvement Network (SURGIN). Increasing the use of perioperative risk scoring in emergency laparotomy: nationwide quality improvement programme. BJS Open 6(4):zrac092. https://doi.org/10.1093/bjsopen/zrac092

    Article  PubMed  PubMed Central  Google Scholar 

  21. Nahm FS (2022 Feb) Receiver operating characteristic curve: overview and practical use for clinicians. Korean J Anesthesiol 75(1):25–36. https://doi.org/10.4097/kja.21209

    Article  PubMed  PubMed Central  Google Scholar 

  22. Boey J, Choi SK, Poon A, Alagaratnam TT (1987) Risk stratification in perforated duodenal ulcers. A prospective validation of predictive factors. Ann Surg 205(1):22–26. https://doi.org/10.1097/00000658-198701000-00005

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Buck DL, Vester-Andersen M, Møller MH (2013) Danish Clinical Register of Emergency Surgery. Surgical delay is a critical determinant of survival in perforated peptic ulcer. Br J Surg 100(8):1045–1049. https://doi.org/10.1002/bjs.9175

    Article  CAS  PubMed  Google Scholar 

  24. Boyd-Carson H, Doleman B, Cromwell D, Lockwood S, Williams JP, Tierney GM et al (2020) Delay in source control in perforated peptic ulcer leads to 6% increased risk of death per hour: a nationwide cohort study. World J Surg 44(3):869–875. https://doi.org/10.1007/s00268-019-05254-x

    Article  CAS  PubMed  Google Scholar 

  25. Søreide K, Thorsen K, Søreide JA (2014) Strategies to improve the outcome of emergency surgery for perforated peptic ulcer. Br J Surg. 101(1):e51–e64. https://doi.org/10.1002/bjs.9368

    Article  PubMed  Google Scholar 

  26. Murray V, Burke JR, Hughes M, Schofield C, Young A (2021) Delay to surgery in acute perforated and ischaemic gastrointestinal pathology: a systematic review. BJS Open 5(5):zrab072. https://doi.org/10.1093/bjsopen/zrab072

    Article  PubMed  PubMed Central  Google Scholar 

  27. Møller MH, Engebjerg MC, Adamsen S, Bendix J, Thomsen RW (2012) The Peptic Ulcer Perforation (PULP) score: a predictor of mortality following peptic ulcer perforation A cohort study. Acta Anaesthesiol Scand 56(5):655–662. https://doi.org/10.1111/j.1399-6576.2011.02609.x

    Article  PubMed  Google Scholar 

  28. Menekse E, Kocer B, Topcu R, Olmez A, Tez M, Kayaalp C (2015) A practical scoring system to predict mortality in patients with perforated peptic ulcer. World J Emerg Surg 21(10):7. https://doi.org/10.1186/s13017-015-0008-7

    Article  Google Scholar 

  29. McCulloch P, Altman DG, Campbell WB, Flum DR, Glasziou P, Marshall JC et al (2009) No surgical innovation without evaluation: the IDEAL recommendations. Lancet. 374(9695):1105–1112. https://doi.org/10.1016/S0140-6736(09)61116-8

    Article  PubMed  Google Scholar 

  30. Agrawal S, Sharma D, Raina VK (1999) Arterial pH and arterial oxygenation are not essential for risk stratification in perforation peritonitis. Indian J Gastroenterol. 18(1):5–6

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, NSCB Government Medical College Jabalpur (MP), Jabalpur, 482003, India

    Uday Somashekar, Mritunjay Kumar Gupta, Arpan Mishra, Rohit Shrivastava, S Bharath, Vikesh Agrawal, Pawan Agarwal & Dhananjaya Sharma

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  1. Uday Somashekar
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Somashekar, U., Gupta, M.K., Mishra, A. et al. Jabalpur Prognostic Scoring System: Revisited After 2 Decades. Indian J Surg 86, 153–159 (2024). https://doi.org/10.1007/s12262-023-03824-x

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