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To Predict the Prognosis in Patients with Perforative Peritonitis Using Mannheim Peritonitis Index and Multiple Organ Failure Score

Shilpa Huchannavar, Associate Professor, Department of General Surgery, Karnataka Institute of Medical Sciences (KIMS), Hubballi, Karnataka 580022 , Shilpa Huchannavara , Sandeep K.S.b , Nishanth Lakshmikanthac

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New Indian Journal of Surgery 9(1):p 71-77, Jan-Feb 2018. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9118.14

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Abstract

Background: Perforative peritonitis is one of most important infectious problems that a surgeon faces on a day to day basis. Despite advances in surgical techniques, antimicrobial therapy and intensive care support its management continues to be highly demanding. Early and objective classification of the severity of peritonitis using the Mannheim peritonitis index (MPI) and the Multiple Organ failure (MOF) scoremay help in selecting patients for aggressive surgical approach.

Aim: Evaluating the prognostic value of Mannheim Peritonitis Index and Multiple Organ Failure score in patients with perforative peritonitis and predicting their outcome.

Methods: Prospective evaluation of the MPI and MOF score was performed in 82 patients with peritonitis who underwent uniform surgical treatmentfrom December 2013 to December 2014 in the Department of General Surgery, KIMS Hubli. Patients were followed up until death or discharge.

Results: Overall inhospital mortality rate was 18 %. Patients with MPI scores of  20, 2129, 30 had a mortality of 5%, 28%, and 60% respectively with a mean MPI of 19.9 in the survivors and 29.06 among the expired patients. When Multiple Organ Failure score was analysed, it showed that mortality was only 5% if the score was less than or equal to 3. But, when it becomes more than 3, mortality reached 90%.

Conclusion: The combined MPI and MOF score have a great impact on the prognosis of patients in perforative peritonitis. They help stratifying the patients according to risk category to minimise the complications postoperatively.

 

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9118.14

Keywords

Perforative Peritonitis; Mannheims Peritonitis Index; Multiorgan Failure Score; Prognosis; Outcome. 

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