EFFICACY OF MANNHEIM PERITONITIS INDEX (MPI) SCORE IN PATIENTS WITH PERFORATION PERITONITIS IN A TERTIARY CARE SETUP
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 1778-1784
Abstract
Introduction: Peritonitis is an inflammatory or suppurative response of the peritoneal lining to direct irritation. Surgical treatment for perforation peritonitis is highly demanding and very complex. The combination of improved surgical technique, antimicrobial therapy, and intensive care support has improved the outcome of such case. A scoring system which can compare patient populations and severity of illness, objectively to evaluate the treatment strategy is the required for evaluative research of intensive care. The present study was undertaken to evaluate the efficacy of Mannheim Peritonitis Index (MPI) score in patients with perforation peritonitis.Materials and Methods: The present prospective study was carried among 50 patients ofperitonitis. Using history, clinical examination and lab values risk factors found in MPI were classified according to values indicated and individual variable scores were added to establish MPI score. The cases were grouped into three: those below 21 points, between 21-29 points, and those above 29points. The data was analyzed, each variable in the MPI score along with other patient variables was analyzed using chi square analysis with various outcomes that were noted in the study. P value <0.05 was taken as significant in this study.
Results: Around 80% of high risk group (MPI > 29) required more than 5 days of ICU stay. High risk group (MPI>29) has more complications than intermediate(MPI 21 TO 29) and low risk group.(MPI <21).Most common complication found in this study is Surgical site infection. Up to 60% patients with score >29 developed surgical site infection in post operative period which was about 42% in patients with score 21 -29 and about 19% in patients with score <21.Around 69% of patient who required inotropic support in post operative period had score of>29 and only one (7%) required inotropes with score <21. 75% of patient who developed endotoxic shock in post operative period had score >29. 40% patients with score >29 developed multi organ dysfunction. All the patients who developed MODS died. Thus, development of MODS post operatively is bad predictor of mortality.
Conclusion: Among the various variables of the scoring system duration of pain, organ failure on presentation and presence of feculent exudates these factorshad a significant hand in predicting the eventual outcome of thepatient.
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