Enliven: Surgery and Transplantation

Is Mannheim Peritonitis Index Needed in Perforation Peritonitis?
Author(s): Dr. Sadiq Husain, Dr. Mohammad Habib Raza, and Dr. Sadik Akhtar

Introduction Peritonitis is inflammation of the peritoneum which lines the abdominal cavity. An effective scoring system is essential to prognosticate the outcome in patients with secondary peritonitis, which is one the most common surgical emergencies in the world.

Material and Methods Prospective Observational Study, conducted at Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh between November 2017 to October 2019. A total of 498 patients of perforation peritonitis of more than 18 years of age were included in the study.

Results Total 498 patients of >18 years were included in the study. 377 were males (75.7%) whereas 121 were females (24.3%). Male to female ratio was 3.2:1. Mean age of the patients was 36.8 years. Mortality due to perforation peritonitis was almost twice in females compared to males (31.4% vs 16.18%). The mortality observed in patients having MPI score <21, 21-29 and >29 was 2.59%, 7.11% and 47.37% respectively. Sensitivity of 84.8% and specificity of 77.2% at a MPI score of 28 was observed. Positive predictive value of Mannheim Peritonitis Index was 52% and negative predictive value was 95.4% at score of 28.

Conclusion Mannheim Peritonitis Index is a simple yet powerful tool to predict the outcome and should be used routinely in patients of perforation peritonitis.