Evaluation of Mannheim Peritonitis Index in Predicting the Prognosis of Hollow Viscus Perforation

Background: Peritonitis due to hollow viscous perforation continues to be one of the most common surgical emergencies and a potentially life threatening condition attended by a surgeon on emergency duty. Its accurate diagnosis and management is still a challenge to surgeons worldwide. A scoring system should be able to assess the need, type, and quality of the care required for a particular patient. Realizing the need for a simple and accurate scoring system in these conditions, the present study was undertaken to evaluate the performance of MPI scoring system in predicting the overall risk of morbidity and mortality in patients with peritonitis due to hollow viscous perforation as the published Indian studies to assess the validity of this scoring system are only a handful. The MPI Scoring system is a relatively easy scoring system to calculate with the available facilities and infrastructure in the institution this study was carried out. Aim: To predict the risk of mortality and morbidity in patients with peritonitis due to hollow viscous perforation in a sample study of 100 patients & to study the prognostic factors which determine the outcome of the disease. Patients& Methods: This study is a clinical, prospective, observational and open study conducted at NRI Medical College & General Hospital during a period of 2 years on 100 patients. MPI scoring system was done in all patients and patients were classified according the scores into 3 groups. Results: MPI scoring system was done on all patients depending on preoperative and intraoperative finding and patients were categorized into the three categories. In the score group of <21 it is observed that 94.23% of the patients survived, 5.77% had Morbidity and 0% had mortality. In the score group of 21-29 it is observed that 17.24% of the patients survived, 41.38% had Morbidity and 41.38% had mortality. In the score group of >29 it is observed that 0% of the patients survived without any complications, 15.78% had Morbidity and 84.22% had mortality. A threshold index score of MPI is derived at 27 for predicting the Mortality with a Sensitivity of 80% , Specificity of 91.94 % and a PPV = 76.19%. Conclusion: The results of this study proves that MPI scoring system is a simple and effective tool for assessing this group of patients, and can be used as a guiding tool to decide on the management of the patient after the definitive procedure is done.