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Background: Despite advances in critical care medicine, prognosis in peritonitis due to hollow viscous perforation remains poor especially when associated with multi-organ dysfunction. Various grading systems are available to analyse and stratify patients by different parameters and predict outcome. In a prospective non randomised observational study, the efficacy of Mannheim peritonitis Index (MPI) was analysed in predicting the outcome in patients treated for peritonitis due to hollow viscous perforation. Methods: A total of 100 consecutive patients with peritonitis undergoing surgical treatment at SDM College of Medical Sciences Hospital Dharwad, were included in study. Demographic, clinical data, evaluation with surgical treatment, outcome details were documented and analyzed using SPSS software. Results: The mean MPI score in this study was 23.81 with 11 lowest and 39 as the highest. The overall mortality was 14% and morbidity 35%. MPI scores of ˂21, 21-29 and ˃29 had an overall mortality of 0%, 3%, and 11% respectively. MPI score of 29 had sensitivity of 87.21%, specificity of 78.57% and predictive power of 0.945 in predicting mortality. Higher mortality rates were associated with presence of multi- organ failure, duration of symptoms of more than 24 hours, faecal peritonitis and presence of malignancy. The sensitivity and specificity for morbidity at MPI score of 29 were 86.14% and 83.58% respectively. Conclusions: The study clearly suggests increasing risk of mortality, morbidity and overall hospital stay with increasing MPI score. The MPI scoring system is simple and effective in predicting outcome of patients with peritonitis. |
