{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:49:42Z","timestamp":1790282982587,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Limited data exists on Charlson's weighted index of comorbidity (WIC) predictability for postoperative outcomes following perforated peptic ulcer (PPU) surgery. This study assesses the utility of WIC and other predictive scores in forecasting both postoperative mortality and morbidity in PPU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials &amp; Methods<\/jats:title><jats:p>Patients with PPUs operated between 2018 and 2021 in a Malaysian tertiary referral center were included. Clinical data were retrospectively analyzed for association with mortality and morbidity measured with the Comprehensive Complication Index (CCI). Predictability of WIC and other predictors were examined using area under receiver\u2013operator characteristic (ROC) curve (AUC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 110 patients included, 18 died (16.4%) and 36 (32.7%) had significant morbidity postoperatively (High CCI, \u226526.2). Both mortality and high CCI were associated with age &gt;65\u00a0years, female sex, comorbidities (diabetes mellitus, hypertension, and renal disease), and American Society of Anesthesiologist score &gt;2. Most patients who died had renal dysfunction, metabolic acidosis, lactate &gt;2\u00a0mmol\/L upon presentation preoperatively. While surgery &gt;24\u00a0h after presentation correlated with mortality and high CCI, the benefit of earlier surgery &lt;6\u00a0h or &lt;12\u00a0h was not demonstrated. WIC (AUC, 0.89; 95% CI, 0.81\u20130.99) showed similar predictability to Peptic Ulcer Perforation (PULP) (AUC, 0.97; 95% CI, 0.93\u20131.00) for mortality. PULP effectively predicted high CCI (AUC, 0.83; 95% CI, 0.73\u20130.93; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>WIC is valuable in predicting mortality, highlighting the importance of comorbidity in risk assessment. PULP score was effective in predicting both mortality and high CCI. Early identification of patients with high perioperative risk will facilitate patients' triage for escalated care, leading to a better outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12162","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T15:43:58Z","timestamp":1712072638000},"page":"1373-1384","source":"Crossref","is-referenced-by-count":5,"title":["A comparative analysis of Charlson's weighted index of comorbidity and perforated peptic ulcer scores in predicting postoperative mortality and high comprehensive complication index"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8243-9812","authenticated-orcid":false,"given":"Raymond Zhun Ming","family":"Lim","sequence":"first","affiliation":[{"name":"Department of General Surgery Hospital Sultanah Aminah  Johor Bahru Johor Malaysia"},{"name":"Department of Surgery Faculty of Medicine Universiti Kebangsaan Malaysia (National University of Malaysia)  Bangi Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9833-5164","authenticated-orcid":false,"given":"Jih Huei","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of General Surgery Hospital Sultanah Aminah  Johor Bahru Johor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8604-8918","authenticated-orcid":false,"given":"Novinth Kumar","family":"Raja Ram","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine Universiti Malaya  Kuala Lumpur Wilayah Persekutuan Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0621-9276","authenticated-orcid":false,"given":"Henry Chor Lip","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of General Surgery Hospital Sultanah Aminah  Johor Bahru Johor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan Khor Ee","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of General Surgery Hospital Sultanah Aminah  Johor Bahru Johor Malaysia"},{"name":"Department of Surgery Faculty of Medicine Universiti Kebangsaan Malaysia (National University of Malaysia)  Bangi Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1439-8027","authenticated-orcid":false,"given":"Jun Sen","family":"Chuah","sequence":"additional","affiliation":[{"name":"Department of General Surgery Hospital Sultanah Aminah  Johor Bahru Johor Malaysia"},{"name":"Department of Surgery Faculty of Medicine Universiti Kebangsaan Malaysia (National University of Malaysia)  Bangi Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0566-7181","authenticated-orcid":false,"given":"Hans Alexander","family":"Mahendran","sequence":"additional","affiliation":[{"name":"Department of General Surgery Hospital Sultanah Aminah  Johor Bahru Johor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521003783320"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(15)00276\u20107"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068\u2010017\u20100777\u20107"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2019.05.001"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010014\u20102485\u20105"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000521288"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757\u20107241\u201021\u201025"},{"issue":"14","key":"e_1_2_10_9_1","first-page":"2623","article-title":"Comparison of Charlson\u2019s Weighted Index of Comorbidities with the Chronic Health Score for the Prediction of Mortality in Septic Patients","volume":"127","author":"Cui Y.","year":"2014","journal-title":"Chinese Medical Journal"},{"key":"e_1_2_10_10_1","unstructured":"CCI\u00ae Calculator[Internet]. 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