Title: Mannheim Peritonitis Index as an Evaluative Tool in Predicting Mortality and Morbidity in Patients with Hollow Viscus Perforation Peritonitis
Authors: Dr Sreenidhi GM, Dr Nitish S, Dr Satya Vani K
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.83
Abstract
Background: Despite advances in diagnosis, surgery, antimicrobial therapy and intensive care support, secondary peritonitis remains a potentially fatal condition especially if not treated at the earliest. Early assessment by scoring systems will influence the management and prognosis.
Aim: Evaluation of Mannheim Peritonitis Index (MPI) score for predicting the Mortality and Morbidity in patients with hollow viscus perforation peritonitis.
Materials and Methods: Prospective study of 100 patients with peritonitis due to hollow viscus perforation who presented to Kempegowda Institute of Medical Sciences
HOSPITAL, BANGALORE from October 2014 to August 2016. The structured scoring system i.e. MPI was applied along with other clinical and biochemical parameters recorded in pre-structured proforma. Data was analysed for predicting mortality and morbidity using EPI info and SPSS software.
Results: The overall mortality and morbidity was 19% and 57% respectively. MPI scores of ≤ 20, 21-29, and ≥ 30 had a mortality of Nil, 4%, and 15% respectively. MPI score of 30 had highest sensitivity of 100% and specificity of 91.43% in predicting mortality, 80.65% sensitivity and 75.83% specificity for morbidity. MPI score of > 25 were associated with 6.45 times higher risk of mortality (p=0.03), 5.72 times higher risk of morbidity (p=0.005) compared to patients with MPI score ≤ 25.
Conclusion: The MPI is a specific score, which has a good accuracy and provides an easy way to handle with clinical parameters, allowing the prediction of the individual prognosis of patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management and hence it should be used routinely in clinical practice.
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