Evaluation of Mannheim’s peritonitis index in predicting mortality in perforative peitonotis patients

Abstract

Background:The prognosis of peritonitis and intra-abdominal sepsis, especially if there is a multi-organ dysfunction is poor in spite of improved surgical and medical management. Therefore, an early prognosis of the severity of the disease is essential for reducing the mortality. Manheim peritonitis index (MPI) is based on measuring very simple clinical parameters, which are routinely performed at the admission to the hospital and preoperatively. This study was conducted to assess the efficacy of MPI system for prognosis of peritonitis.  

Methods: 200 patients who presented with acute abdominal pain were evaluated and erect X-ray abdomen and CT abdomen were done. Blood was collected and sent to the lab for complete blood count, hemoglobin levels, BUN, serum creatinine, blood urea, total bilirubin and direct bilirubin.  Mannheim’s peritonitis index score of each patient was calculated at the first laparotomy.

Results:The mortality rate were higher in the patients with MPI >29 with 61.5%, with a preponderance of males (77.5%). Cardiovascular complications were common in the patients with MPI scores >29, followed by pulmonary complications. In the MPI score 21-29, the most common complication was surgical site infections. The most common origin of sepsis was the 1st part of duodenum followed by ileum.  

Conclusions:It is very easy to perform and very reliable. Patients above the age of 50 years were found to be more susceptible with many having organ failures.