A prospective study evaluating utility of Mannheim peritonitis index in predicting prognosis of perforation
Rajesh Sharma1, Vikrant Ranjan1, Suraj Jain1
1Department of General Surgery, Sri Aurobindo Medical College and PostGraduate Institute, Indore, Madhya Pradesh, India.
Aims:
We aimed to validate Mannheim peritonitis index (MPI) for prediction of outcome in patients with perforation peritonitis.
Materials And Methods:
A prospective study involving 100 subjects operated for perforation peritonitis over the period of 2 years was designed. Postevaluation of predesigned performa, MPI score was calculated and analyzed for each patient with death being the main outcome measure. The MPI scores were divided into three categories; scores <15 (category 1), 16-25 (category 2), and >25 (category 3).
Results:
Our study consisted of 82 males and 18 females (male:female ratio 4.56:1), with the mean patients age of 37.96 ± 17.49 years. 47, 26, and 27 cases belonged to MPI score categories 1, 2, and 3, respectively. The most common origin of sepsis was ileal with small intestine dominating the source of perforation. When the individual parameters of MPI score were assessed against the mortality only, age >50 years (P = 0.015), organ failure (P = 0.0001), noncolonic origin of sepsis (P = 0.002), and generalized peritonitis (P = 0.0001) significantly associated with mortality. The sensitivity of MPI was 92% with a specificity of 78% in receiver operating characteristic curves.
Conclusion:
MPI is an effective tool for prediction of mortality in cases of perforation peritonitis.
Insights
The Mannheim peritonitis index (MPI) effectively predicts mortality in patients with perforation peritonitis. This validated tool aids in assessing patient outcomes and guiding treatment strategies for this critical condition.
Area of Science:
- Surgical outcomes research
- Critical care medicine
- Peritonitis diagnostics
Background:
- Perforation peritonitis presents a significant challenge in surgical emergencies.
- Accurate prediction of patient outcomes is crucial for effective management.
- The Mannheim peritonitis index (MPI) is a scoring system used to assess the severity of peritonitis.
Purpose of the Study:
- To validate the Mannheim peritonitis index (MPI) for predicting mortality in patients diagnosed with perforation peritonitis.
- To assess the effectiveness of MPI in stratifying risk and guiding clinical decisions.
Main Methods:
- A prospective study was conducted with 100 patients undergoing surgery for perforation peritonitis over two years.
- MPI scores were calculated for each patient, with mortality serving as the primary outcome measure.
- Patients were categorized into three groups based on MPI scores: <15, 16-25, and >25.
Main Results:
- The study included 82 males and 18 females, with a mean age of 37.96 years.
- MPI score distribution: 47 in category 1, 26 in category 2, and 27 in category 3.
- Significant predictors of mortality included age >50, organ failure, noncolonic origin of sepsis, and generalized peritonitis (P < 0.05).
- The MPI demonstrated a sensitivity of 92% and a specificity of 78% in predicting mortality.
Conclusions:
- The Mannheim peritonitis index (MPI) is a validated and effective tool for predicting mortality in patients with perforation peritonitis.
- MPI aids in risk stratification and can inform clinical management strategies for improved patient outcomes.
