TO PROGNOSTICATE THE OUTCOME IN PATIENT WITH PERFORATION PERITONITIS BY EVALUATING MANNHEIM PERITONITIS INDEX & APACHE-II SCORING SYSTEM

Abstract

Introduction: Peritonitis presents most commonly due to the localized or generalized infection. Studies have reported APACHE II to be a better system for prognostication of the outcome of patients with peritonitis, while others concluded that MPI provides a more reliable means of risk evaluation. The present study is conducted with the objective to nd out efcacy of MPI in comparison to APACHE II to prognosticate the outcome in patients with perforation peritonitis. Material and methods: This was a prospective hospital based analytical study conducted in department of surgery at Dr. BRAM Hospital, Raipur of Pt. JNMCH Raipur. Total 100 patients with peritonitis fullls the inclusion criteria was included in the study. Both scoring system is applied for the individual patient at admission or within 24 hours. Data was analysed using SPSS version 20.0. Descriptive statistics; frequency, percentage statistical signicance and p value were calculated. Results: The mean age of study subjects was 43.89±15.75 years. Of that (84%) were males. The chief complaint was abdominal pain and not passing atus. The primary outcome shows that one third was died during treatment and rests were discharged. The mean APACHE-II and MPI score among death cases was 14.7 and 25.2. APACHE-II score has sensitivity of 83% and specicity of 94% whereas MPI score has sensitivity of 51% and specicity of 77%. Conclusion: Though MPI did not prove to be as good as APACHE II in this study, there is denitely benet in using the MPI scores in primary and secondary level hospitals where facilities are less and investigations such as blood gas may not be available. They can be used to ascertain a certain extent of the patient's present condition and the prognosis