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A comparative analytical study on outcome of secondary peritonitis using Mannheim's peritonitis index in

Ankan Ghosh1, Anindya Halder1, Nirmalya Sen2

  • 1Department of General Surgery, All India Institute of Medical Sciences, Kalyani, India.

Turkish Journal of Surgery
|May 2, 2024
PubMed
Abstract

Insights

The Mannheim Peritonitis Index (MPI) effectively predicts outcomes in Indian patients with secondary peritonitis. A high MPI score (>29) indicates severe risk, necessitating aggressive treatment to reduce mortality.

Area of Science:

  • Gastroenterology
  • Surgical Infections
  • Prognostic Scoring Systems

Background:

  • Secondary peritonitis arises from alimentary tract perforation, a serious condition.
  • The Mannheim Peritonitis Index (MPI) is a validated prognostic tool for peritonitis outcomes.
  • Understanding MPI's efficacy in diverse populations like India is crucial for clinical practice.

Purpose of the Study:

  • To assess the effectiveness of the MPI scoring system in predicting outcomes for Indian patients with secondary peritonitis.
  • To analyze variations in MPI score-based predictions across different geographical regions in India.

Main Methods:

  • A cross-sectional analysis of published studies on secondary peritonitis from 10 Indian locations was conducted.
  • Published data were compared with in-house data to evaluate MPI parameter variations.
  • Patients were stratified into mild (<21), moderate (21-29), and severe (>29) risk groups based on MPI scores.

Main Results:

  • Mortality showed a significant correlation with age and gender, consistent with global findings.
  • Perforations in Indian patients predominantly occurred in the upper alimentary tract (gastro-duodenal).
  • Higher mortality in India is linked to delayed presentation, sepsis, organ failure, and disease evolution time.

Conclusions:

  • MPI scoring demonstrates effectiveness in predicting risk across diverse Indian populations.
  • MPI scores exhibit reliable sensitivity and specificity.
  • An MPI score >29 strongly suggests the need for aggressive resuscitation, broad-spectrum antibiotics, and intensive care to mitigate mortality and morbidity.
Keywords:
Mannheim’s peritonitis indexSecondary peritonitisinfectionmortality

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