Evaluation of Mannheim Peritonitis Index in Secondary Peritonitis in HUSM

Abstract

Management of peritonitis continues to be a challenge inspite of recent advances in surgical care and technology . Many scoring systems have been developed to study the associated risk factors in order to predict the outcome and develop strategies for improved care. The objective of this study was to evaluate the Mannheim Peritonitis Index (MPI) in determining the outcome of patients operated for secondary peritonitis in Hospital Universiti Sains Malaysia (HUSM). A total of 113 patients with peritonitis undergoing surgical treatment at HUSM between 1 Jan 2013 and 31Oct 2014 were included in the study. Demographic and clinical data, and findings at surgery were documented and analysed using SPSS software . Pearsons Chi-square was used as a statistical test for significance with p value ≤ 0.05. The mean MPI score was 25.22(±8.03) with the lowest score of 10 and highest of 43. The threshold MPI score was 26.5 and there was only 1 death which occurred below this score. The significant predictive factors for mortality were age >50 years, gender, organ failure and diffuse generalised peritonitis. Further, all parameters for MPI affected the scoring except source of sepsis from noncolonic origin. The ROC curve for mortality showed a sensitivity of 94.7% and specificity of 70.2% at a threshold MPI of 26.5. The MPI score is a simple and effective means to predict the outcome of patients with secondary peritonitis in HUSM.