Effectiveness of Mannheims peritonitis index in predicting the mortality and morbidity in patients with hollow viscous perforation in GMKMCH, Salem

Abstract

Background: Successful management of peritonitis is a challenge to surgeons inspite of various advancements in medicine and surgical techniques. The outcome depends on various factors and early intervention. This led to the development of disease severity grading systems that would help grouping the patients by individual risk factors and appropriately predict possible outcome.Methods: The prospective study was conducted in the Department of General Surgery, Government Mohan Kumaramangalam Medical College Hospital, Salem. The study population included 100 patients presenting with perforative peritonitis in the emergency department. Preoperative data like age, gender, preoperative symptom duration and operative data like appearance of exudate, extent of exudates, source of sepsis where noted. Tissue biopsies were followed up. Duration of hospital stay and other postoperative complications were also noted. Patients were followed up till their discharge. The study end point was at patient’s discharge or death.Results: Among the patients who had the maximum score >29, 11% of the patients belonged to age group beyond 50 years. Mortality was 7%. The specificity and sensitivity of morbidity prediction was 89% and 88.9% respectively. The specificity and sensitivity of mortality prediction was 91.40% and 100% respectively. Mortality was highest in patients with score >29.Conclusions: Mannheim peritonitis index is a simplified scoring system with variables that can be assessed preoperatively, intraoperatively and postoperatively, to assess mortality and morbidity and instil appropriate treatment protocols which will bring out a positive outcome in the patients and increase survival rate.