Published: 2021-04-28

Effectiveness of Mannheim peritonitis index scoring system in predicting the morbidity and mortality in peritonitis due to hollow viscous perforation

Sachin Murukanahalli Basavaraju, Akshatha Hebbale Srinivas, Rakshitha Janardan


Background: To study the spectrum and prognostic factor in perforation peritonitis. To evaluate the outcome of patients and identification of high risk patients using Mannheim peritonitis index.

Methods: 80 patients with hollow viscous perforation admitted in the Dept. of Surgery Adhichuchanagiri Institute of Medical sciences from January 2019 to June 30 2020 were included in the study. Necessary data was collected; MPI score was calculated for each patient and analysis done.

Results: The number of post-operative complications, hospital stay and mortality proportionately increased with the MPI score. In our study Age >50 years, Organ failure at admission pre operatively and MPI scoring found to be statistically significant. Out of the 8 variables used in this scoring system, age more than 50 years and organ failure on admission carried more significance in predicting the morbidity and mortality in the post operative period than the other variables.

Conclusions: Mannheim peritonitis index is a simple and effective method in predicting the mortality and morbidity of patients with hollow viscous perforation.


Peritonitis, Scoring systems, Outcome predictors

Full Text:



Bohnen J, Boulanger M, Meakins JL, Mclean APH. Prognosis in generalized peritonitis: relation to cause and risk factors. Arch Surg. 1983;118:285-90.

Giessling U, Petersen S, Freitag M, Kleine-Kraneburg H, Ludwig K. Surgical management of severe peritonitis. Zentralbl Chir. 2002;127:594-7.

Farthmann EH, Schoffel U. Principles and limitations of operative management of intra-abdominal infections. World J Surg. 1990;14:210-7.

Ponting GA, Sim AJW, Dudley HAF. Comparison of local and systemic Sepsis in predicting survival. Br J Surg. 1987;74:75052.

Bion J. Outcome in Intensive care. BMJ. 1993;307:953-54.

Knaus WA, Drapper EA, Wagner DP, Zimmerman JE. APACHE severity of disease classification system. Crit Care Med. 1985;13:818-29 .

Kologlu M, Elker D, Altun H, Sayek I. Validation of MPI and PIA II in two different groups of patients with secondary peritonitis. Hepatogastroenterology. 2001;48:147-51.

Bosscha K, Reijnders K, Hulstaert PF, Algra A, van der Werken C. Prognostic scoring systems to predict outcome in peritonitis and intra-abdominal sepsis. Br J Surg. 1997;84(11):1532-4.

Wacha H, Linder MM, Feldman U, Wesch G, Gundlach E, Steifensand RA. Mannheim peritonitis index – prediction of risk of death from peritonitis: construction of a statistical and validation of an empirically based index. Theoretical Surg. 1987;1:169-77.

Correia MM, Thuler LCS, Velasco E, Vidal EM, Schanaider A. Peritonitis Index in oncologic patients. Revista Brasileira de Cancerologia. 2001;47(1):63-8.

Rodolfo L. Bracho-Riquelme MC, Men C, Mannheim Peritonitis Index Validation Study at the Hospital General de Durango (Mexico), Cir Circuj 2002;70:217-25.

F. Ntirenganya, G. Ntakiyiruta,I.Kakande :Prediction of outcome using the Mannheim peritonitis Index. East central Afric J Surg. 2012;17.

Quereshi AM, Zafer A, Saeed K, Quddus A. Predictive power of Mannheim peritonitis index”. J coll Physician’s surgery Pakistan. 2005;15(11):693-6.

Jhobta RS, Attri AK. Spectrum of performation peritonitis in India-review of 504 consecutive cases. World J Emerg Surg. 2006;1:26.

Quereshi AM, Zafer A, Saeed K, Quddus A. Predictive power of Mannheim peritonitis index” J coll Physician’s Surg Pakistan. 2005;15(11):693-6.