Accuracy of Mannheim Peritonitis Index in Predicting Outcome of Patients with Secondary Peritonitis

Manzoor Ahmed, Muhammad Iqbal, Maria Mehmood, Mukhtar Mehboob, Sayed Abdul Nasir, Runia Aziz Panazai

Abstract

Objective

To evaluate prognostic value of Mannheim Peritonitis Index (MPI) in predicting the outcome of patients with secondary peritonitis.

Study design

Retrospective cross sectional observational study.

Place & Duration of study

Department of Surgery, Bolan Medical College Quetta, from January 2023to April 2024.

Methods

A total of 111 patients above 16-years of age who presented with secondary peritonitis and underwent exploratory laparotomy were enrolled in the study. The eight prognostic variables of MPI; age, gender, organ dysfunction, presence of malignancy, reporting time of more than 24-hours or less, source of peritonitis, extent of peritonitis, and characteristics of peritoneal exudates, were recorded. MPI score categorized into group1 (score <21), group 2 (score 21-29) and group 3 (score >30). Patients were followed for 30-days to find out the early morbidity and mortality.

Results

The male to female ratio was 2.7:1. Majority (n=81 - 73.9%) of the patients were less than 50-years of age. The number of patients who presented after 24-hours were 101 (91%). The shock was recorded in 104 (93.7%) patients. Generalized secondary peritonitis was noted in 91 (81.1%) patients with source being perforated appendix in 73 (33.3%) followed by small bowel perforation (n=34 - 30.6%). The peritoneal fluid was purulent in 69 (62.2%) patients and feculent in 22 (19.8%). Fifty-one (45.9%) patients had score on MPI <21 (n=34 -30.6%). The overall mortality was 12.6% (n=14).

Conclusion

The MPI score calculated showed significant correlation with morbidity and mortality.   

Key words

Secondary peritonitis, Preoperative shock, Mannheim Peritonitis Index, Mortality.