Mannheim Peritonitis Index in Acute Peritonitis due to Hollow Viscus Perforation- A Prognostic Evaluation

Abstract

Introduction: Peritonitis caused by hollow viscus perforation remains a significant cause of mortality, despite advancements in surgical and medical interventions. The Mannheim peritonitis index (MPI) is a widely recognized scoring system that predicts outcomes in peritonitis cases. This study aims to evaluate the prognostic value of MPI in patients with peritonitis due to hollow viscus perforation and assess its ability to predict post-operative outcomes.

Material and Methods: This prospective observational study was conducted at Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, from August 2022 to January 2024. Ethical approval was obtained prior to the study. The sample size included 50 patients aged 18 years or older who presented with peritonitis and required surgical intervention. Diagnostic and biochemical tests were conducted, and MPI scores were calculated pre-operatively. Post-operative outcomes, including discharge and mortality, were recorded. Statistical analysis was performed using chi-square tests.

Results: A patient of >50 years of age, with onset of symptoms >24 hours before surgery, with no organ failure, with malignancy, with generalized peritonitis, with clear intra-operative exudates and with higher MPI score showed higher mortality. The study’s final outcome showed a mortality rate of 40% (20 patients), with 60% (30 patients) discharged. Wound infections were the most common post-operative complication (42%).

Conclusion: MPI proved to be an effective tool in predicting post-operative outcomes in hollow viscus perforation-related peritonitis. Higher MPI scores were associated with increased mortality, underscoring the importance of early risk stratification