Prognostic predictive value of Mannheim peritonitis index in secondary peritonitis: A prospective study

Background: secondary peritonitis still remains a significant surgical presentation with high morbidity and mortality. many scoring systems have been devised to assess prognosis in such patients including apache ii,possum and mannheim peritonitis index (mpi). among these scoring systems,mpi is relatively simple system utilized in european patients with good sensitivity and specificity. aim: to prospectively analyze the value of mpi in assessing prognosis in pakistani patients. methods: in this prospective study 133 patients with at least 2-quadrant peritonitis were enrolled over a period of 6 years from 2003 to 2009 at a tertiary setting. mpi score were analyzed for each patient with death being the main outcome measure. the mpi scores were divided into three categories; scores <15 (category 1),16-25 (category 2),and >25 (category 3). spss version 11 was used to calculate the various outcome measures and receiver operator curves (roc). results: this prospective study consisted of 93 males and 40 females (m: f ratio 4.3:1),with the mean patients age of 42.96±12.1 years. these patients were categorized to mpi score categories 1(n=58),2(n=42),and 3(n=34),respectively. the most common origin of sepsis was small gut perforation followed by appendicular and colorectal perforations. when the individual parameters of mpi score were assessed against the mortality; age >50 years (p=0.00001),organ failure (p=0.00001),colonic origin of sepsis (p= 0.008),and generalized peritonitis were significantly associated with mortality. conclusion: mpi is an effective tool for prediction of mortality in cases of perforation peritonitis,which may be helpful for the surgical team to take aggressive surgical decisions to improve patient outcome. © 2016,lahore medical and dental college. all rights reserved.