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Evaluation of Prognosis in Patients’ with Perforation Peritonitis Using Mannheim’s Peritonitis Index

Amit Singh, Assistant Professor, Department of General Surgery, J.L.N Medical College, Ajmer, Rajasthan, India, 305001. , Parihar Ummed Singh* , Singh Amit** , Samota Ramjilal*** , Kumawat Ghanshyam*** , Echara Mohan Lal*** , Sharma Gunjan***

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New Indian Journal of Surgery 8(2):p 7-13, April - June 2017. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8217.1

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Abstract

Background: Perforation peritonitis is quite common surgical emergency in India as well as worldwide. There are various prognostic indexes available for evaluation of prognosis in patients with peritonitis but none of them is ideal and universally accepted. Our study is to evaluate prognosis in patient with perforation peritonitis using Mannheim’s peritonitis index.

Material and Methods: A prospective observational study of 100 patients with secondary peritonitis due to hollow viscous perforation was conducted at J.L.N. Medical College, Ajmer, Rajasthan (India). Evaluation of prognosis was done using Mannheim’s Peritonitis Index, after dividing the patients into three categories according to the total score.

Results: In our study of 100 patients, 19% patients were having MPI Scores > 29 and mortality rate among these patients was 68.4%, 29% patients were having MPI 21-29 with mortality of 10.3% and 52% patients were having MPI Score < 21 and mortality rate was ZERO% , which is statistically significant with Chi-square value 51.656 and p-value 0.001 (< 0.05). In our study, total 18% patients developed wound infection, out of these 16.7% patients were having MPI Score < 21, 55.6% patients were having MPI Scores between 21-29, while 27.7% patients were having MPI Score > 29.

Conclusion: We concluded that MPI is accurate, reliable and simple scoring index for evaluation of the patients with peritonitis and for estimating their mortality and morbidity risk. Our study differs in two adverse outcome variables, female sex & non-colonic origin of sepsis and we advocate need for further studies on Mannheim Peritonitis Index to include colonic origin of sepsis and to remove female sex as variables of adverse outcome in Mannheim Peritonitis Index.

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8217.1

Keywords

Peritonitis; Mannheim’s Peritonitis Index; Sepsis; Organ Failure; Exudates. 

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