title: Efficacy of Mannheim Peritonitis Index (MPI) Score in Patients with Secondary Peritonitis.
abstract: BACKGROUND
  Despite advances in diagnosis, management and critical care of patients with peritonitis due to hollow viscus perforation, prognosis remains poor. Early assessment by scoring systems will influence the management and prognosis.
  
  
  OBJECTIVE
  Evaluation of Mannheim Peritonitis Index (MPI) score for predicting the outcome in patients with peritonitis.
  
  
  METHODS
  Prospective study of 50 patients admitted and operated for peritonitis in JSS Medical College Hospital. The structured scoring system i.e. MPI was applied along with other clinical and biochemical parameters recorded in pre-structured proforma. Data was analysed for predicting mortality and morbidity using EPI info and SPSS software.
  
  
  RESULTS
  The overall mortality and morbidity was 14% and 38% respectively. MPI scores of ≤ 20, 21-29, and ≥ 30 had a mortality of 5%, 14%, and 50% respectively. MPI score of 25 had highest sensitivity of 72.09% and specificity of 71.43% in predicting mortality, 80.65% sensitivity and 57.89% specificity for morbidity. MPI score of > 25 were associated with 6.45 times higher risk of mortality (p=0.03), 5.72 times higher risk of morbidity (p=0.005) compared to patients with MPI score ≤ 25.
  
  
  CONCLUSIONS
  MPI is disease specific, easy scoring system for predicting the mortality in patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management and hence it should be used routinely in clinical practice.
authors: Resident, Department of General Surgery, JSS Medical College , Mysore, Karnataka, India .
authors: Muralidhar
authors: M
authors: V A
authors: Professor and Unit Head, Department of General Surgery, JSS Medical College , Mysore, Karnataka, India .
authors: Madhu
authors: M
authors: C P
authors: Associate Professor, Department of General Surgery, JSS Medical College , Mysore, Karnataka, India .
authors: Sudhir
authors: S
authors: S
authors: Assistant Professor, Department of Emergency Medicine, JSS Medical College , Mysore, Karnataka, India .
authors: Madhu
authors: M
authors: Srinivasarangan
keywords: Predictor; Scoring; Sepsis
references: Scand J Surg. 2004;93(3):204-8
references: 15544075
references: J Coll Physicians Surg Pak. 2005 Nov;15(11):693-6
references: 16300704
references: BMJ. 1993 Oct 16;307(6910):953-4
references: 8241904
references: Br J Surg. 1994 Feb;81(2):209-13
references: 8156338
references: Hepatogastroenterology. 2001 Jan-Feb;48(37):147-51
references: 11268952
references: Br J Surg. 1987 Aug;74(8):750-2
references: 3651784
references: Br J Surg. 1997 Nov;84(11):1532-4
references: 9393271
references: Indian J Gastroenterol. 2005 Sep-Oct;24(5):197-200
references: 16361763
references: Langenbecks Arch Chir. 1994;379(6):347-52
references: 7845160
references: Zentralbl Chir. 2002 Jul;127(7):594-7
references: 12122587
references: World J Surg. 1990 Mar-Apr;14(2):210-7
references: 2183484
references: Br J Surg. 2006 May;93(5):616-22
references: 16607684
references: Nepal Med Coll J. 2009 Jun;11(2):83-7
references: 19968144
references: Ulus Travma Acil Cerrahi Derg. 2010 Jan;16(1):27-32
references: 20209392
references: Arch Surg. 1983 Mar;118(3):285-90
references: 6824428
references: Crit Care Med. 1985 Oct;13(10):818-29
references: 3928249