Evaluation of Mannheim peritonitis index to predict outcome of patients with hollow viscus perforation

Abstract

Background: Acute generalized peritonitis from gastrointestinal hollow viscus perforation is a potentially life-threatening condition. Mannheim peritonitis index (MPI) is a specific scoring system that facilitates early identification of patients with severe peritonitis for aggressive surgical approach and improved outcomes.Methods: A prospective observational study in 60 patients attending surgical emergency unit with perforation peritonitis was conducted to analyse the predictive capacity of MPI. MPI score was categorized into 3 groups: <21, 21 to 29 and >29. Data was compared for predicting mortality and morbidity. P value, chi square test and 95% CI were used as statistical tools.Results: Two thirds of 60 patients studied were younger than 50 years of age. Prognosis was poorer in patients above 50 years with age. 80% presented after 24 hours. Ileal perforation was the commonest etiology. Morbidity and mortality were worst in patients with MPI score >29.Conclusions: Mannheim peritonitis index is disease specific, easy to apply and effective scoring system predicting the outcome in perforation peritonitis, with increasing MPI score being directly proportional to higher mortality and morbidity of the patient.

A comparative study between Mannheims peritonitis index and Boeys score in predicting the morbidity and mortality in perforated pertic ulcer patients in a tertiary health care center in Bangalore

“…7 peritonitis is defined as an inflammatory process of the peritoneum which is a thin tissue that covers the visceral organs and lines thee inner wall of te abdominal cavity. 11 High mortality in peritonitis patients is due to multiorgan failure, renal failure, sepsis and respiratory distress. The mean age of the patients included in our study was 44.53 years and more common in male gender.…”

A comparative analytical study on outcome of secondary peritonitis using Mannheim’s peritonitis index in geographically diverse Indian patients

“…Independent study variables for MPI scoring system included: age in completed years, sex, malignancy (present/absent), organ failure (present/absent), evolution time (>24 hours/<24 hours), extension of peritonitis (localized/diffuse), origin of sepsis (noncolonic/colonic), character of exudates (clear/faecal/purulent) as described previously (12)(13)(14). We also curated available published data of MPI based studies from India for our comparative analysis (17)(18)(19)(20)(21)(22)(23)(24)(25)(26).…”

“…We utilized an 8-parameter-based scale deployed in all studies for assessing MPI scores as described in study detail. In order to understand the prevalence and pattern of secondary peritonitis across India, we compared our in-house study with 10 other published studies that had used MPI scoring system from various states of India (17)(18)(19)(20)(21)(22)(23)(24)(25)(26). Studies from different geographical locations were selected to have an idea about the epidemiological diversity of secondary peritonitis across India (Figures 1A, 1B).…”

“…MPI based system is often advantageous over other scoring systems for better management of the disease, patient segregation, prognostic reliability and specificity (15,16). Additionally, we performed a comparative analysis of studies with secondary peritonitis throughout India using MPI based scoring parameters and provided a bird's eye view regarding risk factors of the disease (17)(18)(19)(20)(21)(22)(23)(24)(25)(26). The purpose of the study was to understand the variability in outcome due to MPI score parameters across Indian patients with diverse background and predict the overall effectiveness of the MPI scoring system used for accessing risk groups in secondary peritonitis.…”