DOI: http://dx.doi.org/10.18203/2349-2902.isj20201539

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

Jotdeep Singh Bamrah, Gopal Swaroop Bhargava, Manu Kohli

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.


Keywords


Mannheim peritonitis index, Hollow viscus perforation, Peritonitis

Full Text:

PDF

References


Bosscha K, Reijnders K, Hulstaert P, Algra A, van der Werken C. Prognostic scoring systems to predict outcome in peritonitis and intra-abdominal sepsis. Br J Surg. 1997;84(11):1532-4.

Wacha H, Linder MM, Feldman U, Wesch G, Gundlach E, Steifensand RA. Mannheim Peritonitis Index - Prediction of risk of death from peritonitis: construction of a statistical and validation of an empirically based index. Theoratical Surg. 1987;1:169-77.

Billing A, Frölich D, Schildberg FW. Prediction of outcome using the Mannheim Peritonitis Index in 2003 patients. Br J Surg. 1994;81:209-13.

Sharma S, Singh S, Makkar N, Kumar A, Sandhu MS. Assessment of severity of peritonitis using Mannheim Peritonitis Index. Niger J Surg. 2016;22(2):118-22.

Ohmann C, Wittman DH, Wacha H. Prospective evaluation of prognostic scoring systems in peritonitis. Eur J Surg. 1993;159:267-74.

Kachroo R, Ahmad MN, Zargar HU. Peritonitis - An analysis of 90 cases. Indian J Surg. 1984;46:204-9.

Függer R, Rogy M, Herbst F, Schemper M, Schulz F. Validation study of the Mannheim Peritonitis Index. Chirurg. 1988;59:598-601.

Batra P, Gupta D, Batra R, Kothari R, Deshmukh PR. Mannheim Peritonitis Index as an evaluative tool in predicting mortality in patients of perforation peritonitis. CIB Tech J Surg. 2013;2:30-6.

Chandrashekar N, Prabhakar GN, Gurukiran CS, Shivakumarappa GM, Naveen HM. Study of prognostic factors in perforative peritonitis. J Evol Med Dent Sci. 2013;2:5568-74.

Ermolov AS, Bagdat’ev VE, Chudotvortseva EV, Rozhnov AV. Evaluation of the Mannheim Peritonitis Index. Vestn Khir Im II Grek. 1996;155:22-3.

Qureshi AM, Zafar A, Saeed K, Quddus A. Predictive power of Mannheim Peritonitis Index. J Coll Physicians Surg Pak. 2005;15(11):693-6.

Riquelme RLB, Vela AM, Ramírez AT. Mannheim Peritonitis Index validation study at the Hospital General de Durango (Mexico). Cir Ciruj. 2002;70(4):217-25.

Kusumoto Y, Nakagawa M, Watanabe A, Ishikawa H, Sakaguchi T, Yamada T. Study of Mannheim Peritonitis Index to predict outcome of patients with peritonitis. Jpn J Gastroenterol Surg. 2004;37(1):7-13.

Malik AA, Wani KA, Dar LA, Wani MA, Wani RA, Parray FQ. Mannheim Peritonitis Index and APACHE II - Prediction of outcome in patients with peritonitis. Ulus Travma Acil Cerrahi Derg. 2010;16(1):27-32.

Muralidhar VA, Madhu CP, Sudhir S, Srinivasarangan M. Efficacy of Mannheim Peritonitis Index (MPI) Score in patients with secondary peritonitis. J Clin Diagn Res. 2014;8(12):1-3.

Jain S, Jain M, Jain R. Validation of Mannheim Peritonitis Index in a tertiary care center in Rajasthan. Int J Med Sci Public Health. 2015;4:664-8.

Chaudhari ND, Nakum A, Mahida H. Mannheim Peritonitis Index validation study in the Indian set-up. Int J Sci Res. 2014;3:1808-11.