title: Mannheim Peritonitis Index (MPI) and elderly population: prognostic evaluation in acute secondary peritonitis.
abstract: BACKGROUND
  Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people.
  
  
  METHODS
  Retrospective study on 104 patients admitted and operated for "Acute Secondary Peritonitis due to visceral perforation". MPI was scored. In our study we want to demonstrate efficacy of MPI and the possibility to consider older age an independent prognostic factor.
  
  
  RESULTS
  Mortality was 25.96%. Greatest sensitivity and specificity for the MPI score as a predictor of mortality was at the score of 20. MPI score of <16 had 0.15 times lower risk of mortality compared to patients with MPI score 17 - 21 and 0.61 lower than patients with MPI >22. Patients with MPI score 17-21 had 0.46 times lower risk of mortality compared to patients with MPI score >21. In the group of patients with MPI score of >20 the mortality rate was 48.5% for patients older than 80 years old and 12.1% for younger patients (p < 0.005); in the group with MPI score of < 20 mortality rate was respectively 8.4% and 1.4% (p < 0.005).
  
  
  CONCLUSIONS
  Data confirm the accuracy of the test. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis.
authors.forename: G
authors.initials: G
authors.lastname: Salamone
authors.forename: L
authors.initials: L
authors.lastname: Licari
authors.forename: N
authors.initials: N
authors.lastname: Falco
authors.forename: G
authors.initials: G
authors.lastname: Augello
authors.forename: R
authors.initials: R
authors.lastname: Tutino
authors.forename: S
authors.initials: S
authors.lastname: Campanella
authors.forename: G
authors.initials: G
authors.lastname: Guercio
authors.forename: G
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology* / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index