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 Evaluation of Mannheim’s Peritonitis Index in Prediction of Mortality in Patients with Non-traumatic Hollow Viscus Perforation Peritonitis

2021 ◽  
Vol 19 (1) ◽  
pp. 179-184
Author(s):  
Vikal Chandra Shakya ◽  
Anang Pangeni ◽  
Saurav Karki ◽  
Lokesh Raj Sharma
Keyword(s):  
Univariate Analysis ◽  
Individual Risk ◽  
P Value ◽  
Diffuse Peritonitis ◽  
Hollow Viscus ◽  
Predictive Values ◽  
Mortality And Morbidity ◽  
Prediction Of Mortality ◽  
Perforation Peritonitis ◽  
Hollow Viscus Perforation

Background: Hollow viscus perforation peritonitis is one of the commonest surgical emergencies with high mortality and morbidity. The objective of this study was to evaluate the effectiveness of Mannheim’s peritonitis index in prediction of mortality in these patients.Methods: This is a retrospective, observational cohort study in these patients managed in a single-center from January 1, 2013 to December 30, 2019. Total index scores were plotted in the receiver operating characteristic curves to find out the cut-off point. Sensitivity, specificity, relative risk, positive and negative predictive values were calculated. The individual risk factors were analyzed for mortality as well.Results: Case records of 395 cases of non-traumatic hollow viscus perforation peritonitis were available, there were 33 mortalities (8.2%), mean score was 22.96 (+7.6) points (range 10-43 points). The sensitivity and specificity with score cut-off of 25 came to be 75.8% and 56.35%; positive and negative predictive value being 13.7% and 96.2%. Risk of patients for mortality with scores >25 was 3.62 times those with scores <25 for mortality. Mortality rate was 2.4% with scores <21, 8.9% with 21–29 and 20.9% with >29 respectively (p-value <0.05). Univariate analysis showed age >50 years, presence of organ dysfunction, diffuse peritonitis, non-colonic origin and character of exudates were significant factors; multivariate analysis showed only organ failure as significant.Conclusions: Mannheim peritonitis index is very useful in stratification of severity of the disease and prediction of mortality in patients with peritonitis, and should be included in management of all these patients.Keywords: Mannheim’s peritonitis index; perforation peritonitis

scholarly journals A prospective study to evaluate the utility of Mannheim peritonitis index in predicting prognosis of perforation peritonitis at our tertiary care centre

2017 ◽  
Vol 4 (10) ◽  
pp. 3245
Author(s):  
Saravanan K. V. ◽  
Gowri Sankar Alagarsamy ◽  
Udhaya Sankar
Keyword(s):  
Prospective Study ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Mannheim Peritonitis Index ◽  
Generalized Peritonitis ◽  
Post Evaluation ◽  
Prediction Of Mortality ◽  
Perforation Peritonitis ◽  
The Individual ◽  
A Prospective Study

Background: This study was aimed to evaluate the validity of Mannheim Peritonitis Index (MPI) in predicting the outcome in patients with perforation peritonitis.Methods: A prospective study was designed for a study period of 2 years, 75 patients who underwent operation for perforation peritonitis were included in the study. Post evaluation done with predesigned proforma, MPI score was calculated and analyzed for each patient who underwent surgery, death being the main outcome measure. The MPI scores were divided into three categories. MPI scores <15 (category 1), 16-25 (category 2), and >25 (category 3).Results: Present study consisted of 60 males and 15 females (male:female ratio of 4:1) with the mean patients age 37.96±17.49 years. 47, 26, and 27 cases belonged to MPI score categories 1, 2, and 3. The dominating source of perforation was small intestinal. The individual parameters of MPI score were assessed against the mortality, age >50 years (P = 0.015), organ failure (P = 0.0001), noncolonic origin of sepsis (P = 0.002), and generalized peritonitis (P = 0.0001) were the factors significantly associated with mortality. The sensitivity of MPI was 92% and specificity was 78% in receiver operating characteristic curves.Conclusions: MPI is an effective tool for prediction of mortality in cases of perforation peritonitis.

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 A prospective study of Mannheim peritonitis index as a prognostic scale in analysis of outcome in hollow viscus perforation

2018 ◽  
Vol 5 (4) ◽  
pp. 1306
Author(s):  
Abhilash Gautham Ramesh ◽  
Kshama S. Ramesh
Keyword(s):  
Prognostic Index ◽  
Apache Ii Score ◽  
Hollow Viscus ◽  
Mannheim Peritonitis Index ◽  
Surgical Infection ◽  
Generalized Peritonitis ◽  
Reliable Marker ◽  
Intra Abdominal Infection ◽  
A Prospective Study ◽  
Hollow Viscus Perforation

Background: MPI as a prognostic index helps in analysis of prognosis in peritonitis in hollow viscus perforation. The factors that are considered in MPI index are routinely used in assessment of surgical patients, they are easily available, routinely performed, and helps in arrival at a prognosis in fast and effective way.Methods: A prospective survey of patients with acute generalized peritonitis due to hollow viscus perforation was carried out in general surgical wards of our institute during the period starting from January 2014 to December 2015. Study population consisted of 150 consecutive patients with performative peritonitis, which confirmed on emergency laparotomy.Results: The Mannheim peritonitis index emerged as a reliable marker for assessing the severity and prognosis of intra-abdominal infection with sensitivity and specificity comparable to APACHE II score which has been adopted as the gold standard by Surgical Infection Society. The score designed specifically for peritonitis, combines preoperative and operative data and is easy to apply. MPI scores were consistent with low scores among survivors and higher scores among non-survivors.Conclusions: MPI scores in the analysis were sharp predictor of mortality.

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