A Comparative Study between Elebute and Stoner Grading and Mannheim Peritonitis Index in Prognostic Evaluation of Intraperitoneal Sepsis Due to Perforation Peritonitis in Suburban Teaching Hospital

ABSTRACT

Background: Peritonitis is one of the most common surgicalemergencies with significant morbidity and mortality. Multiplescoring systems have been proposed and assessed inpredicting the outcome in patients with peritonitis. A scoringsystem should be able to assess the need, type, and quality ofthe care required for a particular patient. Realizing the need fora simple and accurate scoring system in these conditions, thepresent study was undertaken to evaluate the Prognosticevaluation of intraperitoneal sepsis in perforation peritonitis byevaluating the efficacy of Elebute and Stoner grading andMannheim peritonitis index (MPI) in predicting the overall riskof morbidity and mortality in patients with peritonitis. This studywas conducted to identify the predicting ability of both thesescores and to compare MPI with Elebute and Stoner grading(ESG) system.Aim: To predict outcome of patients with peritonitis using theElebute and Stonjej grading of sepsis and Mannheim peritonitisindex in these patients and to predict the possible clinicaloutcome and to compare the results of both the scoringsystems.Patients & Methods: The present work is based on theobservations made in 48 patients of perforation peritonitisadmitted in surgical ward of Rama Medical College Hapur,Uttar Pradesh, India from March 2017 to March 2018. Thediagnosis of perforation peritonitis was made on the basis ofdetailed history, physical examination, investigations andoperative findings. A detailed record was maintained carefullyfor every patient and evaluation of Elebute and Stoner gradingof sepsis and Mannheim peritonitis index were made and thenresults of both the scoring systems are compared.Results: Comparison of both the scoring systems showed thatsensitivity was almost equal in both the scoring systems (80%).But specificity and accuracy were slightly improved withElebute and Stoner grading of sepsis (89.42% and 87.36% Vs84.16% and 83.22%) respectively. This may be because ofmore organ systems incorporated in Elebute and Stonergrading of sepsis like hepatobiliary system, temperature,bleeding diathesis, central nervous system which had not beenincorporated in Mannheim Peritonitis index.Conclusion: In the univariate analysis both scoring systemsstudied, were relatively accurate for identifying patients athigher risk for dying from peritonitis. It was found thatprediction among the dead was better than survived in both thescoring systems.