Effectiveness of Mannheim peritonitis index in predicting the morbidity and mortality of patients with hollow viscous perforation

Vivek A. Patil; Bibekananda Mahapatra; Anuradha Panchal; Sandesh Deolekar

doi:10.18203/2320-6012.ijrms20170146

Authors

Vivek A. Patil Department of Surgery, Dr. D.Y. Patil Medical College, Nerul, India
Bibekananda Mahapatra Department of Surgery, Dr. D.Y. Patil Medical College, Nerul, India
Anuradha Panchal Department of Surgery, Dr. D.Y. Patil Medical College, Nerul, India
Sandesh Deolekar Department of Surgery, Dr. D.Y. Patil Medical College, Nerul, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20170146

Keywords:

Hollow viscous perforation, MPI, Mortality, Peritonitis

Abstract

Background: Peritonitis due to hollow viscous perforation is common cause of emergency surgery in India. Despite advances in surgical skills, antimicrobial agents and supportive care the morbidity and mortality of secondary peritonitis remains high. Prognosis and outcome of it depends on many factors which includes patient related factors, disease specific factors and management. Categorizing patients into different risk groups would help in management. Mannheim peritonitis index (MPI) is based on measuring simple clinical parameters in case of hollow viscous perforation. This study was conducted to know efficacy of MPI for predicting morbidity and mortality in hollow viscous perforation.

Methods: 50 patients with peritonitis undergoing surgical treatment at Dr. D.Y. Patil medical college, Nerul were included in study. Demographic, clinical data, surgical treatment, outcome were documented and analysed.

Results: The morbidity and mortality rate were higher in patients with MPI >29. Surgical site infections were most common complication in patients with MPI <21. Respiratory complications were common in patients with MPI >21. More ICU stay was required in in patients with MPI <21.

Conclusions: MPI which is very easy to calculate is simple and effective in predicting morbidity and mortality in patients with hollow viscous perforation.

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References

Bion J. Outcome in Intensive care. BMJ. 1993;307:953-4.

Knaus Wa, Drapper EA, Wagner DP, Zimmerman JE. APACHE severity of disease classification system. Crit Care Med. 1985;13:818-29.

Wacha H, Linder MM. Mannheim peritonitis index prediction of risk of death from peritonitis; construction of a static and validation of an empirically based index. Theoritical Surgery. 1987;1:169-77.

Bohen J, Boulanger M, Meakins JL, Mclean AP. Prognosis in generalized peritonitis. Relation to cause and risk factors. Arch Surg. 1983;118:285-90.

Farthmann EH, Schoffel U. Principles and limitations of operative management of intra-abdominal infections. World J Surg. 1990;14:210-7.

Giessling U, Petersen S, Freitag M, Kleine-Kraneburg H, Ludwig K. Surgical management of severe peritonitis. Zentralbl Chir. 2002;127:594-7.

Pacelli F, Battista DG, Alfieri S, Piccioni E, Sgadari A, Gui D, et al. Prognosis in intra- abdominal infections. Arch Surg. 1996;131(6):641-5.

Mannheim Peritonitis Index Validation Study at the Hospital General de Durango (Mexico) Rodolfo L. Bracho-Riquelme MC, M en C, Armando Melero-Vela MC Cir Ciruj. 2002;70:217.

Notash AY, Salimi J, Rahimian H, Fesharaki MH, Abbasi A. Evaluation of Mannheim peritonitis index and multiple organ failure score in patients with peritonitis. Indian J Gastroenterol. 2005;24:197-200.