Abstract

MANNHEIM PERITONITIS INDEX (MPI)- PREDICTING OUTCOMES IN CASES OF SECONDARY PERITONITIS FOLLOWING HOLLOW VISCOUS PERFORATION

Author(s): L. David Livingston, A. Betty Janice, K. Authy

BACKGROUND Secondary peritonitis is defined as infection of the peritoneal cavity due to spillage of organisms into the peritoneum, usually associated with bowel perforation and presents as acute abdomen. It is also termed as Perforation peritonitis. In developing countries like India, secondary peritonitis still remains the most common cause of intra-abdominal sepsis with unacceptably high mortality. The outcome of perforation peritonitis depends on complex interaction of many factors. Various scoring systems do exist for assessing the prognosis of these patients. However, MPI index appears to be more practical and more reliable means of risk evaluation than other scoring systems, such as APACHE-II, which is time consuming, requiring more blood investigations and may be impossible to apply in clinical setting of intra-abdominal sepsis. MATERIALS AND METHODS Source of Data- All patients who were admitted under the department of general surgery with the diagnosis of secondary peritonitis and taken up for exploratory laparotomy. Type of Study- A Prospective, longitudinal case study. Sample Size- 30 patients. RESULTS Patients with increased MPI score had corresponding increase in the rate of complications, which was found to be both clinically and statistically significant. There was delay in initiation of oral diet in patients with increased MPI score. Average hospital stay was three times more in patients with increased MPI score. CONCLUSION Mannheim Peritonitis Index is a simple, reliable accurate index in the assessment of prognosis in patients of peritonitis. High MPI score predicts increased risk of complications, delay in post-operative day of initiation of oral feeds and increased duration of hospital stay.