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[Predictive mortality value of the peritonitis index of Mannheim]
Elizabeth Barrera Melgarejo1, Manuel Rodríguez Castro, Giuliano Borda Luque
1Servicio de Cirugía General y Digestiva, Hospital Campo Arañuelo, Navalmoral de la Mata (Cáceres), España. barreraelizabeth@hotmail.com
Objective:
To determine the predictive value of the index of peritonitis of Mannheim in patients with peritonitis in the Hospital Nacional Cayetano Heredia.
Patients And Methods:
A prospective study appears, of 103 patients, greater of 14 years, with I diagnose of peritonitis, between November 2004 to April 2005. For its analysis I am used the square test of chi with coefficient of Pearson, and the test of T of student. For the analysis of the data two modalities were used, the first patients were divided in 3 groups, according to the value of the index of Mannheim, < 21, of 21 to 29, and > 29, and in 2 groups, d 26 and > 26 points. I am made considered of survival of Kaplan the Meier, using statistical program STATA 8.0
Results:
a mortality of 50% in patients with greater index of 26 points was obtained. One was a sensitivity 95.9%, a specificity of 80%, with positive a predictive value 98.9% and a negative predictive value of 50%. When considering 3 groups, < 21, 21-29 and > 29 points, was a mortality of 60% in patients with greater index of 29. I am made a survival curve obtaining itself a significant difference with a p=0, 0098. Figure 2.
Conclusions:
We found that the classification in 3 groups presents statistically significant difference, reason why recommended its use for the evaluation and beginning of aggressive measures.
Insights
The Mannheim peritonitis index effectively predicts mortality in peritonitis patients. Classification into three groups (<21, 21-29, >29) showed statistically significant differences in outcomes.
Area of Science:
- Clinical Medicine
- Surgical Gastroenterology
- Infectious Diseases
Background:
- Peritonitis poses a significant clinical challenge with variable patient outcomes.
- Accurate prognostic tools are essential for timely and effective management of peritonitis.
Purpose of the Study:
- To evaluate the predictive capability of the Mannheim peritonitis index (MPI) for patient outcomes.
- To assess the MPI's utility in stratifying risk among patients diagnosed with peritonitis.
Main Methods:
- A prospective study included 103 patients over 14 years old diagnosed with peritonitis.
- Statistical analysis involved chi-square and Student's t-tests, with data categorized into groups based on MPI scores (<21, 21-29, >29 and ≤26, >26).
- Kaplan-Meier survival analysis was performed using STATA 8.0.
Main Results:
- A mortality rate of 50% was observed in patients with an MPI score greater than 26.
- The MPI demonstrated high sensitivity (95.9%) and specificity (80%) with a positive predictive value of 98.9%.
- Stratification into three groups revealed a 60% mortality in patients with MPI scores >29, with a significant difference (p=0.0098) in survival curves.
Conclusions:
- The Mannheim peritonitis index is a valuable tool for predicting mortality in peritonitis.
- Classifying patients into three MPI groups (<21, 21-29, >29) provides statistically significant prognostic information.
- Recommended for evaluating patients and initiating aggressive treatment strategies.
