Usefulness of Mannheim’s Peritonitis Index Screening System in Predicting Outcome in Patients with Peritonitis

Abstract

INTRODUCTION Peritonitis is an inflammation of the peritoneum, the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs. Peritonitis may be localized or generalized, and may result from infection (often due to rupture of a hollow abdominal organ as may occur in abdominal trauma or inflamed appendix) or from a non-infectious process. Early prognostic evaluation of patients with peritonitis is desirable to select high-risk patients for intensive management and also to provide a reliable objective classification of severity and operative risk. This study attempts to evaluate the use of scoring Mannheim Peritonitis Index (MPI) in patients with peritonitis. AIM 1. To assess the effectiveness of Mannheim Peritonitis Index (MPI) in predicting mortality in patients who presented with features of peritonitis. OBJECTIVES 1. To study Prognosis according to Mannheim Peritonitis Index. 2. For Early intervention for those in need according to classification. MATERIAL AND METHODS This prospective study was conducted in Dhiraj General Hospital. It was conducted between July 2016 to September 2017. The patients included were the patients who presented with abdominal pain and diagnosed to have peritonitis. INCLUSION AND EXCLUSION CRITERIA Inclusion criteria 1. All the patients referred to or admitted with an acute abdomen and diagnosed to have peritonitis. Exclusion criteria 1. Patient who do not give consent or do not fit in the study criteria. 2. Pediatric Patients will be excluded Result & Analysis The overall mortality in the present study was 22%. MPI scores of ≤ 26, and > 26 had a mortality of 2.96 and 68.75% respectively. MPI score of 26 had highest sensitivity of 92.09% and specificity of 90.43% in predicting mortality. MPI score was higher in patients with organ failure and also mortality rate also were higher in this group of patients where mean MPI score for patients with organ failure was 26.54 while the patients not having organ failure had mean MPI score of 15.54. Conclusion MPI is disease specific, easy scoring system for predicting the mortality in patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management and hence it should be used routinely in clinical practice