Study of Mannheim Peritonitis Index (MPI) in Acute Peritonitis due to Hollow Viscus Perforation - A Prognostic Evaluation

Introduction: Peritonitis is severe inflammation of the peritoneum caused by pathogenic microorganisms and their products. The complex nature of peritoneal infection and the diversity of treatment make evaluation of new diagnostic and therapeutic advances in this field very difficult. MPI score is calculated by collecting data from clinical examination and operative findings that accounts 8 variables: age, sex, organ failure, diagnosis of carcinoma, preoperative duration of peritonitis, origin of sepsis, peritonitis extension, characteristics of exudate. Methods: This was a hospital based observational study of 62 consecutive patients who presented with peritonitis due to hollow viscus perforation in the emergency setting. MPI scoring was done in all patients who were classified those with score less than 21, 21 to 29 and more than 29. Aim: To validate Mannheim peritonitis index (MPI) for prediction of outcome in patients with perforation peritonitis. Objectives: To correlate individual components of MPI with the outcome in patients with perforation peritonitis. To evaluate Mannheim Peritonitis Index in individual patients and to assess the accuracy of predicting the outcome of the patients. Observation and Results: Among 62 patients, 29 patients (53.7%) with MPI less than21 and 25 patients (46.3%) with 21 - 29 were discharged.8 deceased patients were all having MPI 21 - 29. The results were statistically significant with p value of 0.04. As per our study, the MPI score with the cut off value of 21 has a sensitivity of 54% and specificity of 100%. Conclusion: MPI scoring system is easy score to apply, the determination of risk is available during operation and surgeon can know about the possible outcome and the appropriate management can be decided. MPI is more effective in predicting the mortality in peritonitis due to hollow viscous perforation.