FP7.18 - Early Operative Risk Assessment Using Modified Mannheim Peritonitis Index in Patients with Generalised Peritonitis at a Tertiary Hospital in Abuja, Nigeria

Abstract

Abstract Aim This study assessed the usefulness of a modified Mannheim Peritonitis Index (MPI) as a risk stratification tool in predicting surgical outcomes in the management of patients with generalized peritonitis in Abuja, Nigeria. Methods This is a prospective study of consecutive adult patients managed for generalized peritonitis at a tertiary hospital in Abuja Nigeria within a one-year duration. The MPI was modified using respiratory rate and SpO2. Patient characteristics and outcome of treatment obtained were entered into a structured proforma, checked and analysed using the SPSS, version 25. The threshold score of the modified MPI, as well as the accuracy, sensitivity, and specificity, were derived from the receiver-operator characteristic (ROC) curve analysis and its coordinates. Results There were 49 patients with generalised peritonitis during the study period with a male-to-female ratio of 2.5:1. The commonest cause of peritonitis in this study was penetrating abdominal injury (30.6%) followed by complicated appendicitis (24.5%). This study's mortality and morbidity rates were 14.3% and 63.3%, respectively. On the ROC curve, the modified MPI best predict mortality at a threshold score point of ≥26 (Accuracy of 79.4%, sensitivity of 85.7% specificity of 61.9%, P-value = 0.013), and morbidity at a threshold score of ≥23 (Accuracy 78.4%, sensitivity of 77.4%, specificity of 72.2%, P-value = 0.001). Conclusion The modified MPI can be used as a risk assessment tool in predicting postoperative outcomes in adult patients operated for generalised peritonitis within 30 days of operative intervention at Abuja. This modification can be useful in low-resource centres with limited access to arterial blood gas analysers.