Effectiveness of Mannheim peritonitis index scoring system in predicting the morbidity and mortality in peritonitis due to hollow viscous perforation

Abstract

Introduction: Peritonitis due to hollow viscous perforation is one of the common causes for emergency ward admission under surgery department. Its causes vary from the one requiring immediate surgical intervention to that requiring conservative management. Its accurate diagnosis and management is a challenge to every surgeon. Scoring systems that provide objective descriptions of the patients conditions at specific points in the disease process aid our understanding of these problems. Hence this study is undertaken to study the effectiveness of Mannheims peritonitis index in predicting the outcome in peritonitis patients who presented to our hospital. Objectives of the study: To evaluate the prognostic value of MPI scoring system in patients with peritonitis due to hollow viscous perforation. Methodology: This study is a clinical, prospective, observational and open study conducted at Vijayanagara Institute of Medical Sciences, Bellary, from January 2010 to December 2010. The data regarding patient particulars, diagnosis, investigations, and surgical procedures is collected in a specially designed case recording form and transferred to a master chart subjected to statistical methods like mean, standard deviation, proportion, percentage calculation and wherever necessary chi square test for proportion are used. Results : In this study 100 cases of secondary and tertiary peritonitis The mean age of patients was 45.72 (SD 14.26) years ranging from 13 to 75 and majority of patients (68.6%) belonged to age group of 31-45 years and most (72%) presenting after 24 hours of onset of symptoms. 5.8% of patients with MPI score less than 21 developed wound infection with 0 % mortality and 94.2% of patients being normal, 41.4% of patients had morbidity (wound infection) and mortality with MPI score 21 to 27 and those patients with MPI score more than 27 had the highest mortality i.e. 84.2%. Hence effective scoring is system is required to predict the outcome in peritonitis patients and whether the line of management taken is appropriate or need to be changed.