A prospective study of Mannheim peritonitis index as a prognostic scale in analysis of outcome in hollow viscus perforation

Abhilash Gautham Ramesh; Kshama S. Ramesh

doi:10.18203/2349-2902.isj20180991

Authors

Abhilash Gautham Ramesh Department of Surgery, Shimoga Institute of Medical Sciences, Shimoga, Karnataka, India
Kshama S. Ramesh Department of Medicine, AJ Institute Medical Sciences, Kuntikan, Mangaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20180991

Keywords:

Hollow viscus perforation, MPI, Peritonitis

Abstract

Background: MPI as a prognostic index helps in analysis of prognosis in peritonitis in hollow viscus perforation. The factors that are considered in MPI index are routinely used in assessment of surgical patients, they are easily available, routinely performed, and helps in arrival at a prognosis in fast and effective way.

Methods: A prospective survey of patients with acute generalized peritonitis due to hollow viscus perforation was carried out in general surgical wards of our institute during the period starting from January 2014 to December 2015. Study population consisted of 150 consecutive patients with performative peritonitis, which confirmed on emergency laparotomy.

Results: The Mannheim peritonitis index emerged as a reliable marker for assessing the severity and prognosis of intra-abdominal infection with sensitivity and specificity comparable to APACHE II score which has been adopted as the gold standard by Surgical Infection Society. The score designed specifically for peritonitis, combines preoperative and operative data and is easy to apply. MPI scores were consistent with low scores among survivors and higher scores among non-survivors.

Conclusions: MPI scores in the analysis were sharp predictor of mortality.

Metrics

Metrics Loading ...

References

Ahuja A, Pal R. Prognostic scoring indicator in evaluation of clinical outcome in intestinal perforations. JCDR. 2013 Sep;7(9):1953.

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 Jan;16(1):27-32.

Dani T, Ramachandra L, Nair R, Sharma D. Evaluation of prognosis in patients’ with perforation peritonitis using Mannheim’s peritonitis index. Int J Scientific Res Publications. 2015 May;5(5):126-31.

Ukwenya AY, Muhammad I, Nmadu PT. Assessing the severity of intraabdominal Infections; the value of APACHE II Scoring System. Nigerian J Surgical Res. 2006;8(1).

Tavakaaolizadeh A. Small Intestine In: Brunicardi FC. Schwartz’s principles of surgery. 9th Ed. USA: Mc GrawHill; 2010.

Wittmann DH, Schein M, Condon RE. Management of secondary peritonitis. Annals Surg. 1996 Jul;224(1):10.

Notash AY, Salimi J, Rahimian H, Fesharaki MS, Abbasi A. Evaluation of Mannheim peritonitis index and multiple organ failure score in patients with peritonitis. Indian J Gastroenterol. 2005 Sep 20;24(5):197.

Mishra A, Sharma D, Raina VK. A simplified prognostic scoring system for peptic ulcer perforation in developing countries. Indian J Gastroenterol. 2003 Mar;22(2):49-53.

Ohmann C, Wittmann DH, Wacha H. Prospective evaluation of prognostic scoring systems in peritonitis. peritonitis study group. Eur J Surg. 1993 May;159(5):267-74.

Delibegovic S, Markovic D, Hodzic S, Nuhanovic A. Evaluation of prognostic scoring systems in the prediction of the outcome in critically Ill patients with perforative peritonitis. Acta Inform Med. 2010;18(4):191-5.