Publication:

Study of mannheims peritonitis index in patients with peritonitis

Background Patients with perforating peritonitis often present with acute, severe illness that carries a high risk for morbidity and mortality. Mortality ranges from 3-40% and several prognostic scoring systems have been suggested. The aim of this study was to assess the accuracy Mannheim Peritonitis Index (MPI) in the prediction of outcome of patients with peritonitis.

Methods A prospective study of 30 months that had 217 patients presenting with peritonitis at our institute from October 2011 to November 2013.

Results All the MPI variables of adverse outcome namely, presence of organ failure; time elapsed > 24 hrs; presence of malignancy, age > 50 years, generalized extension behaved as expected, except the non-colonic origin of sepsis in peritonitis and female sex. Colonic origin of sepsis was associated with worse outcome probably due to presence of feculent exudates which was more commonly associated with colonic origin of sepsis. Female sex was associated with better outcome as compared to male sex. Our study differs from MPI in these 2 variables of adverse outcome.

Conclusions MPI is accurate to be used with patients with peritonitis and should be considered reliable and simple reference for estimating their risk of death. As our study differs in two adverse outcome variables, female sex & non-colonic origin of sepsis, we advocate need for further studies on Mannheim peritonitis index to include colonic origin of sepsis and to remove female sex as variables of adverse outcome in Mannheim peritonitis index.