Validation And Analysis of Mannheim Peritonitis Index Scoring In Predicting Outcome in Patients With Perforation Peritonitis – A Prospective Study in Tertiary Care Centre
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Background: Despite advances in diagnosis, management and critical care of patients with perforation peritonitis, prognosis remains poor. Early assessment by scoring systems will influence the management and prognosis. Over the years, many prognostic systems have been developed to stratify critical patients into different categories. Some are complex in their application whereas some are not specific for the disease condition. Mannheim peritonitis index (MPI) is one such prognostic system that helps us to estimate the probability of patient survival in cases of perforation peritonitis. Aim of our study is, to confirm the predicative value of MPI and analysis of different parameters among patients with intra-operative diagnosis of perforation peritonitis. Materials and Methods: The study was conducted from May 2014 to April 2015 on 100 patients undergoing surgery for perforation peritonitis. Result: Of the 100 patients, 85 were male and 15 were female. On dividing the patients into two groups based on the MPI score (<26 and ≥26), it was found that there was absence of deaths in patients with scores <26, and increased mortality and morbidity in those with score ≥26 confirmed the predicative value of MPI among patients with perforation peritonitis. Higher mortality rates were associated with presence of age >50, female sex, multi- organ failure, duration of symptoms of more than 24 hours, faecal peritonitis and presence of malignancy. Conclusion: The MPI is one of the simplest scoring systems in use that allows the surgeon to easily determine the outcome risk during initial surgery and probability of patient survival. Also, because of its simplicity of application it can be a very useful tool in countries such as India where there is limitation of resources and lack of ICU facilities.
Authors and Affiliations
Dharmpal Godara, Vijaypal Singh, Rajendra Mandia
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