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Mannheim's peritonitis index in the prediction of postoperative outcome of peritonitis
Laís Dos Santos Gueiros1, Cláudio Medina DA Fonseca1, Nathalia Maria Dias Moraes Duarte2
1- Hospital Santa Casa de Misericórdia de Vitória, Cirurgia Geral - Vitória - ES - Brasil.
Objective:
evaluate the effectiveness of MPI to predict mortality in patients with peritonitis in Santa Casa de Misericordia de Vitoria Hospital (HSCMV).
Methods:
a longitudinal observational cohort retrospectively study, with a sample of 75 patients diagnosed with peritonitis between January 2010 to December 2 of 2015, in HSCMV and with all the necessary criteria for the calculation of IPM.
Results:
we found a profile of the patients, 33 female and 42 male, mean age 42 years, 11 deaths and 14.67% mortality percentage. Comparing the MPI variables into two groups (survivors and deceased) was found that older than 50 years, presence of malignancy and patients with organ dysfunction have statistical significance for mortality, with p<0.05. The MPI ranged between 4-41 points, with average of 21.2 points. However, among the dead, the score ranged from 23 to 41, with a mean of 32.8. Therefore, the cutoff point of 27 points was established by evaluating the best value of Kappa concordance index, and through it were calculated: 90.90% sensitivity and specificity of 78.13% by the ROC curve.
Conclusion:
based on these results, it was established that the MPI was effective in estimating the risk of death when the index reaches values = 27 points. Categorizing patients into different risk groups helps in determining a better prognosis and defining operative risk, thus contributing to the choice of the surgical procedure nature.
Insights
The Mortality in Peritonitis Index (MPI) effectively predicts mortality in peritonitis patients. An MPI score of 27 or higher indicates a significantly increased risk of death, aiding in prognosis and surgical planning.
Area of Science:
- Surgical Outcomes
- Critical Care Medicine
- Prognostic Biomarkers
Background:
- Peritonitis poses a significant mortality risk.
- Accurate prognostic tools are crucial for patient management.
- The Mortality in Peritonitis Index (MPI) is a potential predictor of outcomes.
Purpose of the Study:
- To evaluate the effectiveness of the MPI in predicting mortality.
- To establish a reliable cutoff score for risk stratification in peritonitis patients.
- To assess the MPI's utility in guiding surgical decisions.
Main Methods:
- A retrospective longitudinal observational cohort study.
- Included 75 patients diagnosed with peritonitis between 2010-2015.
- Utilized MPI criteria for risk assessment and outcome analysis.
Main Results:
- The overall mortality rate was 14.67%.
- Factors like age >50, malignancy, and organ dysfunction were significant predictors of mortality (p<0.05).
- An MPI cutoff score of 27 demonstrated 90.90% sensitivity and 78.13% specificity.
Conclusions:
- The MPI is effective in estimating mortality risk in peritonitis patients.
- An MPI score of ≥27 indicates a high risk of death.
- Risk stratification using MPI aids in determining prognosis and optimizing surgical strategy.
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