Rajesh Sharma1, Vikrant Ranjan1, Suraj Jain1, Tulika Joshi2, Anurag Tyagi1, Rohan Chaphekar1
1Department of General Surgery, Sri Aurobindo Medical College and PostGraduate Institute, Indore, Madhya Pradesh, India.
2Department of Obstetrics and Gynecology, Index Medical College Hospital and Research Institute, Indore, Madhya Pradesh, India.
Aims: We aimed to validate Mannheim peritonitis index (MPI) for prediction of outcome in patients with perforation peritonitis. Materials and Methods: A prospective study involving 100 subjects operated for perforation peritonitis over the period of 2 years was designed. Postevaluation of predesigned performa, MPI score was calculated and analyzed for each patient with death being the main outcome measure. The MPI scores were divided into three categories; scores <15 (category 1), 16-25 (category 2), and >25 (category 3). Results : Our study consisted of 82 males and 18 females (male:female ratio 4.56:1), with the mean patients age of 37.96 ± 17.49 years. 47, 26, and 27 cases belonged to MPI score categories 1, 2, and 3, respectively. The most common origin of sepsis was ileal with small intestine dominating the source of perforation. When the individual parameters of MPI score were assessed against the mortality only, age >50 years (P = 0.015), organ failure (P = 0.0001), noncolonic origin of sepsis (P = 0.002), and generalized peritonitis (P = 0.0001) significantly associated with mortality. The sensitivity of MPI was 92% with a specificity of 78% in receiver operating characteristic curves. Conclusion : MPI is an effective tool for prediction of mortality in cases of perforation peritonitis.
Keywords: Mannheim peritonitis index, perforation peritonitis, receiver operating characteristic curve.