A Prospective Analytical Study Comparing The Effectiveness of Mannheim Peritonitis Index, APACHE-II And P- Possum in Predicting the Mortality of Patients with Perforative Peritonitis

This is a prospective analytical study done on 50 patients with perforative peritonitis in Govt Rajaji Hospital, Madurai. The objective of the study was to analyse Mannheim Peritonitis Index, APACHE-II and pPOSSUM by comparing Discriminatory ability, Positive predictive value, Sharpness of prediction and Reliability of prediction. Online calculators were used to calulate risk of mortality and statistical analysis was done with SPSS Version 15 for Windows.MPI score is apt for hospitals in a peripheral setting as it does not overemphasize on intensive monitoring and biochemical values.APACHE-II is a highly accurate score with good reliability at higher scores and moderate sharpness. p-POSSUM is less difficult to calculate than APACHE-II and as if not more reliable. None of the scores here provide a dynamic assessment of the patient as they are a calculated only once at a particular point of time. APACHE-II seems to be the ideal score; still using more than one score may improve the sharpness and reliability of prediction.