Publication: Effectiveness of Mannheim Peritonitis Index in Predicting the Morbidity and Mortality of Patients with Hollow Viscus Perforation
Date
2018
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
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.
KEY WORDS
Mannheim peritonitis index, Morbidity, Mortality, Perforation peritonitis
Description
Karki OB,1 Hazra NK,1 Timilsina B,1 Kunwar D2
1Department of Surgery
Manipal College of Medical Sciences,
Phulbari-11, Pokhara, Nepal.
2Department of Conservative Dentistry and Endodontics,
Gandaki Medical College,
Pokhara, Nepal
Keywords
Mannheim peritonitis index, Morbidity, Mortality, Perforation peritonitis