Comparative Study of Modified Boey’s Score and Mannheim Peritonitis Index in Predicting Outcome of Perforated Peptic Ulcer with Diffuse Peritonitis

Abstract

Background: Perforated Peptic Ulcer (PPU) complicated with diffuse peritonitis despite all advances of diagnosis and surgical care. The timely and precise identification of prognosis is one of the most key issues to optimize peri-operative management. In this study, the Modified Boey's Score (MBS) and the Mannheim Peritonitis Index (MPI) were compared and assessed for their predictive capabilities in patients with PPU after surgery.

Methods: A prospective observational study was done in the Department of General Surgery from October 2025 to February 2026 with 50 patients with perforated peptic ulcer and diffuse peritonitis. Both MBS and MPI were calculated for each patient. Postoperative morbidity and mortality were tabulated and analyzed to test the predictive performance by using Chi-square test and Receiver Operating Characteristic (ROC) analysis.

Results: Mean age of the patients was 46.2 years and 88% were male. The overall morbidity was 62% and the mortality was 14%. Morbidity and mortality increased with rising MBS values: 4.35%, 31.25%, 88.89%, and 57.14% (morbidity) and 0%, 3.12%, 16.67%, and 100% (mortality) for scores 0-3, respectively. Based on the results of the ROC analysis, MBS had a higher AUC value (AUC=0.81) than MPI (AUC=0.68).

Conclusion: Modified Boey's Score was a more convenient, rapid and accurate means of predicting morbidity and mortality in patients with diffuse peritonitis and perforated peptic ulcer than Mannheim Peritonitis Index. It is also easily applied at the bedside, which is beneficial for early risk assessment and management planning.

Keywords: Modified Boey’s Score; Mannheim Peritonitis Index; Perforated Peptic Ulcer; Morbidity; Mortality

Citation

Adeel Asghar. Comparative Study of Modified Boey’s Score and Mannheim Peritonitis Index in Predicting Outcome of Perforated Peptic Ulcer with Diffuse Peritonitis. WebLog J Biotechnol Biomed Eng. wjbtbe.2026.h0808. https://doi.org/10.5281/zenodo.21860443