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General Surgery Emergency Medicine Standard surgical risk scoring

Boey Score (Perforated Peptic Ulcer)

Predicts mortality after emergency surgery for perforated peptic ulcer. Three simple risk factors.

Severe cardiac, respiratory, renal, or hepatic disease (ASA III or above)

SBP < 90 mmHg on admission

Duration from onset of symptoms to hospital presentation

Score interpretation

Low Risk 0

Boey Score 0: No risk factors. Mortality ~0–5%.

→ Proceed to surgery. Laparoscopic repair preferred. Good prognosis.

Moderate Risk 1

Boey Score 1: One risk factor. Mortality ~10–15%.

→ Surgery required. Consider open vs laparoscopic based on surgeon expertise. Informed consent includes significant mortality risk.

High Risk 2

Boey Score 2: Two risk factors. Mortality ~45%.

→ High-risk surgical consent. ICU post-op mandatory. Consider conservative management only if extremely frail.

Very High Risk 3

Boey Score 3: All three risk factors. Mortality ~100%.

→ Discuss with patient and family regarding prognosis. Consider palliative / conservative management. If surgery, ICU essential. Specialist HPB / upper GI surgical review.

Interpretation bands for the Boey. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.