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

2021 ◽  
Vol 8 (5) ◽  
pp. 1490
Author(s):  
Sachin Murukanahalli Basavaraju ◽  
Akshatha Hebbale Srinivas ◽  
Rakshitha Janardan
Keyword(s):  
Organ Failure ◽  
Scoring System ◽  
Morbidity And Mortality ◽  
Medical Sciences ◽  
Mannheim Peritonitis Index ◽  
Mortality And Morbidity ◽  
Post Operative Period ◽  
Operative Complications ◽  
Risk Patients ◽  
Perforation Peritonitis

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.

scholarly journals Mannheim Peritonitis Index (Mpi) Score as A Predictor of Outcome in Patients with Secondary Peritonitis

2018 ◽  
Vol 4 (2) ◽  
pp. 6-9
Author(s):  
Pravin Joshi ◽  
Rajesh Poudel ◽  
Kailash Chandra
Keyword(s):  
Retrospective Study ◽  
Scoring Systems ◽  
Age Group ◽  
Medical Sciences ◽  
Mannheim Peritonitis Index ◽  
Bacterial Peritonitis ◽  
Post Operative Period ◽  
Surgical Emergencies ◽  
Perforation Peritonitis ◽  
The Common

INTRODUCTION: Secondary bacterial peritonitis from hollow viscous perforation is one of the common surgical emergencies and carries higher mortality. Several scoring systems are applied to predict the outcome of patients with perforation peritonitis. Mannheim Peritonitis Index (MPI) is one among many. Our aim of the study is to evaluate Mannheim peritonitis Index for predicting the outcome in patient with secondary bacterial peritonitis. MATERIALS AND METHODS: A retrospective study was conducted in the Department of General Surgery, Universal College of Medical Sciences, Bhairahawa from February 2012 to July 2013. All patients clinically diagnosed as peritonitis and who underwent laparotomy were included in the study. MPI score of all the study patients were calculated and categorized into three groups depending upon the score; less than 15, 15-25 and more than 25. Mortality of patients from each group was calculated and predictive value of each factor was determined.  RESULTS: Total 60 patients were included in the study. Forty-four were male and sixteen were female. There were total five mortalities. All were of above 50 years age group. Patients beyond 50 years of age had a significantly higher (p = .005) probability of dying in the early post-operative period. MPI score more than 15 was not statistically significant (p = .06), patients with MPI more than 25 had more probability of dying, hazard ratio (HR 3.4 with 95% CI).Journal of Universal College of Medical Sciences (2016) Vol.04 No.02 Issue 14, page: 6-9

EFFICACY OF MANNHEIM PERITONITIS INDEX IN PREDICTION OF MORTALITY AND MORBIDITY IN PATIENTS WITH SECONDARY PERITONITIS

2021 ◽  
pp. 66-68
Author(s):  
Mayank Mangwani ◽  
Subhash Chander Sharma ◽  
Alok Vardhan Mathur
Keyword(s):  
Organ Failure ◽  
Scoring System ◽  
Secondary Peritonitis ◽  
Hollow Viscus ◽  
Irreversible Damage ◽  
Mannheim Peritonitis Index ◽  
Generalized Peritonitis ◽  
Prediction Of Mortality ◽  
Perforation Peritonitis ◽  
Hollow Viscus Perforation

Background: Acute generalized peritonitis following hollow viscus perforation is a potentially life threatening condition leading to a cascade of infective processes, sepsis, disseminated intravascular coagulation, multi organ failure and death in the presence of irreversible damage to the vital organs. Grading the severity of acute peritonitis can contribute in better management of patients with perforation peritonitis. The Mannheim Peritonitis Index (MPI) scoring system takes into account various characteristics like age of the patient, gender, duration of peritonitis, organ failure, Malignancy, colonic sepsis, extent of spread and character of the peritoneal uid. The Objective of this study was to determine the Prognostic value of MPI in patients with Secondary Peritonitis. Methods: In this study conducted at SMI Hospital, Dehradun, Over a period of 1 year, all patients presenting with features of Peritonitis due to hollow viscus perforation were included. MPI score of all the patients were calculated and categorized into three groups; less than 21, 21-29 and more than 29. Mortality of patients from each group was calculated and predictive value of each factor was determined. Results:Total 150 patients were included in this study. There were total 21 mortalities. For patients with a score <21, the mortality rate was 0%; for score 21–29, it was 4.3%; and for score >27, it was 67.9% (P < 0.001). Age> 50 years, presence of organ failure, malignancy, presentation after 24 hours, generalized peritonitis and Fecal exudate were associated with higher mortality rates. Conclusions: MPI is a simple and useful scoring system to determine the prognosis and complications in patients with perforation peritonitis.

scholarly journals Evaluation of Mannheim peritonitis index to predict outcome of patients with hollow viscus perforation

2020 ◽  
Vol 7 (5) ◽  
pp. 1385
Author(s):  
Jotdeep Singh Bamrah ◽  
Gopal Swaroop Bhargava ◽  
Manu Kohli
Keyword(s):  
Scoring System ◽  
P Value ◽  
Predictive Capacity ◽  
Chi Square ◽  
Hollow Viscus ◽  
Mannheim Peritonitis Index ◽  
Mortality And Morbidity ◽  
Generalized Peritonitis ◽  
Perforation Peritonitis ◽  
Hollow Viscus Perforation

Background: Acute generalized peritonitis from gastrointestinal hollow viscus perforation is a potentially life-threatening condition. Mannheim peritonitis index (MPI) is a specific scoring system that facilitates early identification of patients with severe peritonitis for aggressive surgical approach and improved outcomes.Methods: A prospective observational study in 60 patients attending surgical emergency unit with perforation peritonitis was conducted to analyse the predictive capacity of MPI. MPI score was categorized into 3 groups: <21, 21 to 29 and >29. Data was compared for predicting mortality and morbidity. P value, chi square test and 95% CI were used as statistical tools.Results: Two thirds of 60 patients studied were younger than 50 years of age. Prognosis was poorer in patients above 50 years with age. 80% presented after 24 hours. Ileal perforation was the commonest etiology. Morbidity and mortality were worst in patients with MPI score >29.Conclusions: Mannheim peritonitis index is disease specific, easy to apply and effective scoring system predicting the outcome in perforation peritonitis, with increasing MPI score being directly proportional to higher mortality and morbidity of the patient.

scholarly journals Comparative study between POMPP score versus Boey score to predict morbidity and mortality in peptic perforation peritonitis

2021 ◽  
Vol 8 (2) ◽  
pp. 543
Author(s):  
Bhanu Prakash K. R. ◽  
Subhas Patil ◽  
Manasa Mohan
Keyword(s):  
Peptic Ulcer ◽  
Morbidity And Mortality ◽  
High Rate ◽  
P Value ◽  
Peptic Ulcer Perforation ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Perforation Peritonitis

Background: Peptic ulcer disease (PUD) results from an imbalance between stomach acid-pepsin and mucosal defense barriers. It affects 4 million people worldwide annually. Peptic ulcer perforation is one of the most common surgical emergencies and is associated with a high rate of morbidity and mortality. This is due to presence of various risk factors among the population like H. pylori infection, long term NSAID use, alcohol ingestion, smoking and steroid use. Peptic ulcer perforation peritonitis usually requires an emergency surgical intervention and hence the need for this study, to compare POMPP and Boey scores as predictors of morbidity and mortality in patients with peptic perforation peritonitis.Methods: This prospective observational study was conducted in the hospitals attached to Bangalore Medical College and Research Institute from November 2018 to May 2020. All patients above 18 years with features of hollow viscus perforation with per-operative finding of perforated peptic ulcer were included in the study. Patients with histopathology suggestive of malignancy were excluded.Results: A total of 65 patients were included in the study. On analysis of the data by Chi-square test, P value of both POMPP and Boey scores was found to be <0.05 which is statistically significant. The most important predictive factors of mortality and morbidity were duration of perforation >24 hours, age >65 years and pre-operative shock.Conclusions: Both scoring systems are easy to use and can assist in accurate and early identification of high-risk patients and are important in predicting mortality and morbidity in patients with peptic ulcer perforation.

scholarly journals Evaluation of the validity of POSSUM and P-POSSUM score in predicting the risk of morbidity and mortality respectively in patients undergoing emergency laparotomy

2020 ◽  
Vol 7 (10) ◽  
pp. 3224
Author(s):  
Vivian Anandith Paul ◽  
Agnigundala Anusha ◽  
Alluru Sarath Chandra
Keyword(s):  
Mortality Rate ◽  
Linear Method ◽  
Morbidity And Mortality ◽  
Emergency Laparotomy ◽  
Medical Sciences ◽  
Mortality And Morbidity ◽  
Possum Score ◽  
Operative Severity Score ◽  
Significant Difference ◽  
Predicted Values

Background: Aim of this study is to examine the efficacy of Physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and Portsmouth predictor modification (P-POSSUM) equations in predicting morbidity and mortality in patients undergoing emergency laparotomy, to study the morbidity and mortality patterns in patients undergoing emergency laparotomy at Malla Reddy Institute of Medical Sciences, Hyderabad. Methods: The study was conducted for a period of 2 years from February 2018 to February 2020. 100 Patients undergoing emergency laparotomy were studied in the Department of General surgery MRIMS, Hyderabad. POSSUM and P-POSSUM scores are used to predict mortality and morbidity. The ratio of observed to expected deaths (O:E ratio) was calculated for each analysis. Results: The study included total 100 patients, 83 men and 17 women. Observed mortality rate was compared to mortality rate with POSSUM, the O:E ratio was 0.62, and there was no significant difference between the observed and predicted values (χ²=10.79, 9 degree of freedom (df) p=0.148). Observed morbidity rates were compared to morbidity rates predicted by POSSUM, there was no significant difference between the observed and predicted values (χ²=9.89, 9 df, p=0.195) and the overall O:E ratio was 0.91. P-POSSUM predicted mortality equally well when the linear method of analysis was used, with an O:E ratio of 0.65 and no significant difference between the observed and predicted values (χ²= 5.33, 9 df, p= 0.617).Conclusion: POSSUM and P-POSSUM scoring is an accurate predictor of mortality and morbidity following emergency laparotomy and is a valid means of assessing adequacy of care provided to the patient. 

scholarly journals Atlanta Classification for Acute Pancreatitis- A Study Protocol

2021 ◽  
pp. 61-68
Author(s):  
Varun Singh ◽  
Rajasbala Pradeep Dhande ◽  
Gaurav Mishra
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Scoring System ◽  
Necrotizing Pancreatitis ◽  
Classification Systems ◽  
Mortality And Morbidity ◽  
The Past ◽  
Edematous Pancreatitis ◽  
Acute Necrotic Collection

Background: Acute pancreatitis is one of the most common abdominal pathologies having variable outcome ranging from self limiting abdominal pain to high mortality and morbidity due to organ failure, over the past five decades, various classification systems have emerged to classify pancreatitis according to its severity , and the associated complications have emerged to classify acute pancreatitis and its various complications, such as Apache Scoring , Ct Severity , Modified Ct Severity ,Ransen  and Atlanta Classification. Objectives: We in our study will be classifying patients suffering from acute pancreatitis according to the revised Atlanta classification to divide them into interstitial edematous pancreatitis and necrotizing pancreatitis. The local complications will be classified according to CT imaging findings into acute necrotic collection, psuedocyst, acute necrotic collection and walled of necrosis. Organ failure will be assessed according to modified marshal scoring system into transient or persistent organ failure. Methodology: We will be carrying forward our study on   Siemens 16 slice computer tomography machine over a sample of 140 patients coming to the outpatient department of our hospital which will be followed by a routine clinical follow up of the patient to find out their prognosis. Results: Will be tabulated at the end of the study using SPSS version 26 software. Conclusion: The revised Atlanta classification for acute pancreatitis, in conjunction with the Modified Marshall Scoring System for organ failure, if found useful, in our series in improving the prognosis of the patients, then it can be incorporated in management.

scholarly journals Comparison of mannheim peritonitis index and revised multiple organ failure score in predicting mortality and morbidity of patients with secondary peritonitis

2017 ◽  
Vol 4 (10) ◽  
pp. 3499
Author(s):  
S. K. Pattanaik ◽  
A. John ◽  
V. A. Kumar
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Roc Curve ◽  
Scoring Systems ◽  
Multiple Organ ◽  
Secondary Peritonitis ◽  
P Value ◽  
Mannheim Peritonitis Index ◽  
Mortality And Morbidity ◽  
Organ Failure Score

Background: Secondary peritonitis carries high mortality and morbidity. Many scoring systems have been designed to assess its severity. This study was undertaken to compare the Mannheim peritonitis index (MPI) and revised multiple organ failure score (Revised MOFS) in predicting the mortality and morbidity.Methods: A prospective observational study was undertaken in adults operated for gastrointestinal perforation. Clinical and biochemical parameters as required for MPI and Revised MOFS were recorded. Each of the scores were divided under four categories; MPI <14, 14-21, 22-29 and >29; Revised MOFS 0, 1, 2 and >2. Data was compared for predicting mortality and morbidity. P-value, ROC curve and 95% CI were used as statistical tools.Results: Two thirds of 120 patients studied presented after 48 hours. MPI score of <14, 14-21, 21-29 and >29 had mortality of 0%, 2.2%, 27.2% and 50% respectively. ROC curve showed highest sensitivity and specificity of 79% and 70% respectively at MPI of 25. Significant value for mortality was obtained with MPI >25 (p= 0.000012) and with Revised MOFS >1 (p< 0.001); for morbidity with MPI >21 (p= 0.010) and with Revised MOFS >1 (p< 0.001). 20% patients with Revised MOFS zero were also morbid.Conclusions: Both MPI and Revised MOFS systems are good in predicting the mortality, but MPI is easy scoring system and a better option for predicting morbidity. MPI score >25 for mortality and >21 for morbidity are significant.

scholarly journals TO STUDY PROGNOSTIC FACTORS IN PERFORATION PERITONITIS AND EVALUATING THE OUTCOME OF PATIENTS WITH PERFORATION PERITONITIS USING MANNHEIM PERITONITIS INDEX

2020 ◽  
pp. 1-4
Author(s):  
S. Jackison Singh ◽  
Dhanabir Thangjam ◽  
T. Arun Kumar Singh ◽  
N. Somorjit Singh
Keyword(s):  
Prognostic Factors ◽  
Scoring System ◽  
Analytical Study ◽  
Emergency Operation ◽  
Exclusion Criteria ◽  
Mannheim Peritonitis Index ◽  
Surgical Interventions ◽  
Perforation Peritonitis ◽  
Operative Findings ◽  
Eventual Outcome

BACKGROUND: Perforation peritonitis constitutes one of the commonest surgical emergency operation encountered by surgeons all over world as well as in India.There is no single,easily available laboratory test that predicts severity or prognosis in patients with perforation peritonitis. The aim of this study is to study prognostic factors in perforation peritonitis and evaluating the outcome of patients with perforation peritonitis using Mannhein Peritonitis Index. MATERIALS AND METHOD:The study was a prospective analytical study done in the Department of General Surgery, JNIMS,Imphal from 1st September 2017 to 31st august 2019 comprising of 100 consecutive patients in which diagnosis of perforation peritonitis were established by operative findings or surgical interventions during management were included in the study as per the inclusion and exclusion criteria. RESULTS: Among the various prognostic factors of the scoring system, age >50 years, nature of peritoneal fluid exudates and presence of organ failure had a significant role in predicting the eventual outcome of the patients.Colonic origin of sepsis was associated with worse outcome probably due to presence of faecal exudates which is commonly associated with colonic origin of sepsis. MPI < 21 was associated wih complications in 25% of patients whereas complications increases as MPI score increases with 34.5% of patients having complication in MPI ranging from 21-29. CONCLUSION: MPI is disease specific, easy scoring system for predicting outcomes in patients with perforation peritonitis

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