Effectiveness of mannheim peritonitis index in predicting the morbidity and mortality of patients with hollow viscus perforation

Abstract

Background Peritonitis due to hollow viscus perforation is one of common surgical emergency. Its accurate diagnosis and management is a challenge to every surgeon. This led to the development of disease severity grading systems that would aid in management and appropriately predict possible outcome. Objective Evaluation of Mannheim Peritonitis Index (MPI) score for predicting the morbidity and mortality in patients with peritonitis due to hollow viscus perforation. Method Prospective study of 126 patients operated for perforation peritonitis in Manipal College of Medical Sciences, Pokhara, Nepal from May 2015 to April 2018. Mannheim Peritonitis Index score was calculated for each patient. Data was analysed for predicting mortality and morbidity using SPSS 20. Pearson’s Chisquare was used as a statistical test and considered as significant difference if p = 0.05. Result Perforated appendix (35.7%), peptic ulcer perforation (31%) and truma (19%) were common causes of perforation peritonitis. Mean score was 18.55. The overall mortality and morbidity was 9% and 43% respectively with Mannheim Peritonitis Index scores of = 20, 21-29, and = 30 had a mortality of 0%, 14%, and 46% respectively. Presence of generalized peritonitis, organ failure at time of admission, type of intra peritoneal exudate carried more significance in predicting the mortality and morbidity in the post op period than other variables. Conclusion Mannheim Peritonitis Index is a simple and specific scoring system for predicting the mortality in patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management.