A PROSPECTIVE OBSERVATIONAL STUDY TO EVALUATE MANNHEIM PERITONITIS INDEX IN PREDICTING DIFFERENT OUTCOMES OF PATIENTS WITH PERITONITIS

Abstract

Background: Perforation peritonitis is one of the most common surgical emergency case which is encountered in the surgical emergency department,with very high morbidity and mortality. The decision making is very important that which patient need urgent surgery and which patient need resuscitation and surgical intervention later on.To help this there are several scoring system made one of which is Mannheim peritonitis index. In this study we tried to evaluate it and its usefullness in peritonitis patients. Patients and Methods: A prospective observational study conducted over 300 patients of peritonitis admitted in the Surgery Department of LLR Hospital, GSVM Medical College, Kanpur after taking proper consent in which Mannheim peritonitis index was evaluated. From the Results: total 300 patients 233(78%) were men and 40 were expired(13.3%).In expired patients mean MPI score was 29.05 SD7.01. Patients who were alive had mean MPI score 20.79 SD6.1, 194(65%) patients hospitalised for less than 10 days, 106(33%) patients were hospitalised for more than 10 days. In the patients who hospitalised for more than 10 days mean MPI score was 27.68 SD7.43, 96(32%) patients needed ICU care. Mean MPI score in patients who needed ICU care was 30 SD5.93, 15(5%) patients had anastomotic leak postoperatively,In anastomotic leak patients mean MPI score was 27.5 SD6.34, 72(24%) patients had wound dehiscense, Mean MPI score in the patients who had wound dehiscence was 28.03 SD7.008. Patient who faced no morbidity, Had mean MPI score of 12.8 SD3.5. Mortality in male patients was 12.44% and in female patients was 16.41%. Conclusion: Mannheim peritonitis index proved to be a good predictor of morbidity and mortality in the patients of peritonitis, With higher the Mannheim peritonitis index score higher the mortality and morbidity,but has limitations in prediction of some morbidites ljke anastomotic leak.