RESUMO
Background: Peritonitis is defined as inflammation of the peritoneal cavity, caused by a number of etiologic agents including bacteria, fungi, viruses, chemical irritants, and foreign bodies. The Mannheim peritonitis index (MPI) is one of the simple scoring systems in use that allows the surgeon to easily determine outcome risk. Aims and objective: To estimate outcome of patients with perforation peritonitis. To evaluate effect of MPI score in identification of high risk cases.Methods: A prospective study was conducted in 100 patients with peritonitis due to hollow viscous perforation at surgical unit of tertiary care unit. The duration of study was 2 years. All the data was recorded. Written informed consent was obtained and data was analyzed using appropriate analysis strategy.Results: In this study, total 100 patients enrolled, out of which 54 % patients were in the age group <50 years and 46% patients were in the age group >50 years. Mortality was higher among patients with age group more than 50 years (21%) and in female patients (37.93%). 18 patients had organ failure. 87 patients had preoperative duration was >24 hours. 93% patients had non-colonic origin of sepsis. In 52 (52%) patients total MPI score was <21 while 25 (25%) patients total score was 21-29 and it was >29 in 23 (23%) patients. Mortality was higher among patients with MPI Score more than 29 (95.65%).Conclusions: MPI is accurate to be used with patients with peritonitis and should be considered reliable and simple reference for estimating their risk of death. This study differs in one adverse outcome variables, non-colonic origin of sepsis, we advocate need for further studies on Mannheim peritonitis index to include colonic origin of sepsis.
RESUMO
Background: The early assessment and recognition of peritonitis patient is required in surgical emergency. Various scoring system have been designed successfully to assess the prognosis and outcome of peritonitis. The present study was carried out with an aim to evaluate the usefulness and severity of Mannheim peritonitis (MPI) score in comparison to acute physiological and chronic health evaluation II (APACHE II) scoring system for prediction of the outcome in patients with perforation peritonitis and thus decision making in perforation peritonitis.Methods: A prospective observational study was carried out at Department of Surgery, King George’s Medical University (KGMU), Lucknow for a period of one year from July 2018 to June 2019. A total of 100 patients were enrolled in the study.Results: Majority of patients were males compared to females. Maximum number of patients (40%) was aged 51-60 years. Maximum number of patients (42%) had duodenal perforation. A significant association between higher MPI scores and mortality was seen (p<0.001). Statistically, the association between APACHE II scores and mortality was significant (p<0.001).Conclusions: APACHE II had a slightly higher sensitivity as well as specificity as compared to MPI. MPI is easy to calculate but accuracy of APACHE II is more, compared to MPI.