Effectiveness and evaluation of Mannheim peritonitis index scoring system for prediction of mortality and morbidity in patients with peritonitis following hollow viscus perforation

2019 ◽  
Vol 12 (3) ◽  
pp. 124-129
Author(s):  
Jagrutkumar Patel ◽  
Keyword(s):  
Scoring System ◽  
Hollow Viscus ◽  
Mannheim Peritonitis Index ◽  
Mortality And Morbidity ◽  
Prediction Of Mortality ◽  
Hollow Viscus Perforation

EFFICACY OF MANNHEIM PERITONITIS INDEX IN PREDICTION OF MORTALITY AND MORBIDITY IN PATIENTS WITH SECONDARY PERITONITIS

2021 ◽  
pp. 66-68
Author(s):  
Mayank Mangwani ◽  
Subhash Chander Sharma ◽  
Alok Vardhan Mathur
Keyword(s):  
Organ Failure ◽  
Scoring System ◽  
Secondary Peritonitis ◽  
Hollow Viscus ◽  
Irreversible Damage ◽  
Mannheim Peritonitis Index ◽  
Generalized Peritonitis ◽  
Prediction Of Mortality ◽  
Perforation Peritonitis ◽  
Hollow Viscus Perforation

Background: Acute generalized peritonitis following hollow viscus perforation is a potentially life threatening condition leading to a cascade of infective processes, sepsis, disseminated intravascular coagulation, multi organ failure and death in the presence of irreversible damage to the vital organs. Grading the severity of acute peritonitis can contribute in better management of patients with perforation peritonitis. The Mannheim Peritonitis Index (MPI) scoring system takes into account various characteristics like age of the patient, gender, duration of peritonitis, organ failure, Malignancy, colonic sepsis, extent of spread and character of the peritoneal uid. The Objective of this study was to determine the Prognostic value of MPI in patients with Secondary Peritonitis. Methods: In this study conducted at SMI Hospital, Dehradun, Over a period of 1 year, all patients presenting with features of Peritonitis due to hollow viscus perforation were included. MPI score of all the patients were calculated and categorized into three groups; less than 21, 21-29 and more than 29. Mortality of patients from each group was calculated and predictive value of each factor was determined. Results:Total 150 patients were included in this study. There were total 21 mortalities. For patients with a score <21, the mortality rate was 0%; for score 21–29, it was 4.3%; and for score >27, it was 67.9% (P < 0.001). Age> 50 years, presence of organ failure, malignancy, presentation after 24 hours, generalized peritonitis and Fecal exudate were associated with higher mortality rates. Conclusions: MPI is a simple and useful scoring system to determine the prognosis and complications in patients with perforation peritonitis.

scholarly journals Evaluation of Mannheim peritonitis index to predict outcome of patients with hollow viscus perforation

2020 ◽  
Vol 7 (5) ◽  
pp. 1385
Author(s):  
Jotdeep Singh Bamrah ◽  
Gopal Swaroop Bhargava ◽  
Manu Kohli
Keyword(s):  
Scoring System ◽  
P Value ◽  
Predictive Capacity ◽  
Chi Square ◽  
Hollow Viscus ◽  
Mannheim Peritonitis Index ◽  
Mortality And Morbidity ◽  
Generalized Peritonitis ◽  
Perforation Peritonitis ◽  
Hollow Viscus Perforation

Background: Acute generalized peritonitis from gastrointestinal hollow viscus perforation is a potentially life-threatening condition. Mannheim peritonitis index (MPI) is a specific scoring system that facilitates early identification of patients with severe peritonitis for aggressive surgical approach and improved outcomes.Methods: A prospective observational study in 60 patients attending surgical emergency unit with perforation peritonitis was conducted to analyse the predictive capacity of MPI. MPI score was categorized into 3 groups: <21, 21 to 29 and >29. Data was compared for predicting mortality and morbidity. P value, chi square test and 95% CI were used as statistical tools.Results: Two thirds of 60 patients studied were younger than 50 years of age. Prognosis was poorer in patients above 50 years with age. 80% presented after 24 hours. Ileal perforation was the commonest etiology. Morbidity and mortality were worst in patients with MPI score >29.Conclusions: Mannheim peritonitis index is disease specific, easy to apply and effective scoring system predicting the outcome in perforation peritonitis, with increasing MPI score being directly proportional to higher mortality and morbidity of the patient.

scholarly journals Evaluation of Mannheim’s Peritonitis Index in Prediction of Mortality in Patients with Non-traumatic Hollow Viscus Perforation Peritonitis

2021 ◽  
Vol 19 (1) ◽  
pp. 179-184
Author(s):  
Vikal Chandra Shakya ◽  
Anang Pangeni ◽  
Saurav Karki ◽  
Lokesh Raj Sharma
Keyword(s):  
Univariate Analysis ◽  
Individual Risk ◽  
P Value ◽  
Diffuse Peritonitis ◽  
Hollow Viscus ◽  
Predictive Values ◽  
Mortality And Morbidity ◽  
Prediction Of Mortality ◽  
Perforation Peritonitis ◽  
Hollow Viscus Perforation

Background: Hollow viscus perforation peritonitis is one of the commonest surgical emergencies with high mortality and morbidity. The objective of this study was to evaluate the effectiveness of Mannheim’s peritonitis index in prediction of mortality in these patients.Methods: This is a retrospective, observational cohort study in these patients managed in a single-center from January 1, 2013 to December 30, 2019. Total index scores were plotted in the receiver operating characteristic curves to find out the cut-off point. Sensitivity, specificity, relative risk, positive and negative predictive values were calculated. The individual risk factors were analyzed for mortality as well.Results: Case records of 395 cases of non-traumatic hollow viscus perforation peritonitis were available, there were 33 mortalities (8.2%), mean score was 22.96 (+7.6) points (range 10-43 points). The sensitivity and specificity with score cut-off of 25 came to be 75.8% and 56.35%; positive and negative predictive value being 13.7% and 96.2%. Risk of patients for mortality with scores >25 was 3.62 times those with scores <25 for mortality. Mortality rate was 2.4% with scores <21, 8.9% with 21–29 and 20.9% with >29 respectively (p-value <0.05). Univariate analysis showed age >50 years, presence of organ dysfunction, diffuse peritonitis, non-colonic origin and character of exudates were significant factors; multivariate analysis showed only organ failure as significant.Conclusions: Mannheim peritonitis index is very useful in stratification of severity of the disease and prediction of mortality in patients with peritonitis, and should be included in management of all these patients.Keywords: Mannheim’s peritonitis index; perforation peritonitis

scholarly journals Cas/Medevac in field area: An experience and lessons drawn

2019 ◽  
Vol 63 ◽  
pp. 33-38
Author(s):  
Murtaza ◽  
P Biswal
Keyword(s):  
United Nations ◽  
Medical Care ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical Establishment ◽  
Level Ii ◽  
Incremental Information ◽  
Standard Operating ◽  
Field Area ◽  
Hollow Viscus Perforation

Introduction: Success of Cas/Medevac missions depends on effective coordination between all agencies involved. The focus by medical authorities on the treatment and medical care at time leads to avoidable procedural complexity. Certain lessons are drawn from the United Nations (UNs) field areas for Cas/Medevac missions/laid down procedures and recommendations made for streamlining our own procedures. Materials and Methods: The data pertaining to Cas/Medevac details from IFH Level-II Malakal (UN Mission in South Sudan [UNMISS]) for January 2017 - February 2018 were collected and analyzed. Standard operating procedures (SOPs) followed in the UN field areas for Cas/Medevac missions were also studied and analyzed. Results and Discussion: A total of 19 cases were air evacuated from IFH Level-II UNMISS to higher medical establishments and 11 cases from periphery to IFH Level-II in 1 year plus period. Aeromedical issues involved are discussed here with emphasis on Medevac of patient with suspicion of hollow viscus perforation/pancreatitis. Procedures and documentation followed in the UN Medevac missions are discussed and suggestions made for improving Cas/ Medevac procedures in field areas. A sample of Cas/Medevac incremental information form is also suggested. Conclusion: Timely evacuation of a casualty to an appropriate medical establishment can reduce mortality and morbidity significantly. Experience of Cas/Medevac missions in the UN field area is presented in this paper along with analysis and discussion on SOPs followed in the UN mission areas. Suggestions are made to refine and streamline our own Cas/Medevac procedures in field areas and theaters of conflict.

scholarly journals Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.
Keyword(s):  
Perioperative Complications ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Threatening Condition ◽  
Hollow Viscus Perforation

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.

scholarly journals EFFECTIVENESS OF MANNHEIM PERITONITIS INDEX IN PREDICTING THE MORBIDITY AND MORTALITY OF PATIENTS WITH PERITONITIS FOLLOWING HOLLOW VISCUS PERFORATION

2020 ◽  
pp. 48-50
Author(s):  
Pradipta Pandit ◽  
Tanmoy Bhuyan ◽  
Rahul Kushwaha
Keyword(s):  
Surgical Treatment ◽  
Antimicrobial Agents ◽  
Risk Groups ◽  
Morbidity And Mortality ◽  
Related Factors ◽  
Hollow Viscus ◽  
Mannheim Peritonitis Index ◽  
Medical College ◽  
Specific Factors ◽  
Hollow Viscus Perforation

Background: One of the common cause of emergency surgery in India is peritonitis due to hollow viscous perforation. The morbidity and mortality of secondary peritonitis remains high despite advances in surgical skills, antimicrobial agents and supportive care. Many factors determine the prognosis and outcome which includes patient related factors, disease specific factors and management of the case. Management of these case are done by categorizing patients into different risk groups. Based on measuring simple clinical parameters in case of hollow viscous perforation Mannheim peritonitis index (MPI) is calculated. To know efficacy of MPI for predicting morbidity and mortality in hollow viscous perforation this study was conducted. Methods: 50 patients who were undergoing surgical treatment for peritonitis following hollow viscous perforation at Silchar Medical College and Hospital, Silchar were included in study. Clinical data, surgical treatment, outcome were documented and analysed. Results: In patients with MPI more than 29 the morbidity and mortality rate were higher. The most common complication in patients with MPI less than 21 was surgical site infection while of those with MPI more than 21 the respiratory complications were common. The ICU stay of the patients were increased if the MPI Score was higher. Conclusions: MPI is simple and effective in predicting morbidity and mortality in patients with hollow viscous perforation and is very easy to calculate.

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