A simple prognostic scoring system for typhoid ileal perforation peritonitis

Area of Science:

• Surgery
• Gastroenterology
• Public Health

Background:

• Typhoid ileal perforation (TIP) often presents with worse outcomes than initially expected.
• Existing prognostic tools may not be optimally suited for TIP management.
• There is a need for a reliable scoring system to predict TIP patient outcomes.

Purpose of the Study:

• To prospectively evaluate the utility of the Jabalpur prognostic score (JPS) for prognostication in patients with typhoid ileal perforation (TIP).
• To assess the correlation between the JPS and morbidity/mortality rates in TIP patients.
• To determine if the JPS can be adapted for TIP (JPS-TIP).

Main Methods:

• Prospective study of 82 consecutive TIP patients.
• Data collection included six JPS parameters: age, heart rate, mean blood pressure, serum creatinine, co-morbid illness, and perforation-operation interval.
• Statistical analysis to correlate JPS with morbidity and mortality.

Main Results:

• The JPS demonstrated a significant correlation with morbidity and mortality in TIP patients.
• Increasing JPS scores were associated with higher rates of morbidity and mortality.
• Survivors had a significantly lower mean JPS (3.86 ± 2.23) compared to non-survivors (7.94 ± 3.6; P < 0.001).
• TIP patients exhibited worse outcomes compared to peptic perforation peritonitis (PPP) patients across similar stages.

Conclusions:

• The Jabalpur prognostic score (JPS) is a valuable tool for prognosticating outcomes in typhoid ileal perforation (TIP).
• The JPS can be easily modified into JPS-TIP for improved clinical application in TIP.
• This scoring system aids in identifying high-risk TIP patients, potentially guiding treatment strategies.