Efficacy of the Mannheim Peritonitis Index in Predicting the Prognosis of Small Intestinal Perforation: A Retrospective Study

Abstract

Background: A common emergency faced by surgeons is that of small bowel perforation. Despite advancements in medicine, perforation peritonitis still carries a mortality rate of about 10%. The Mannheim Peritonitis Index (MPI) is a tool developed to help prognosticate patients on arrival and direct timely intervention. Most of the studies done previously included all the causes for peritonitis in general. Our hypothesis was that MPI can help grade patients with small intestinal perforation, and based on this scoring, appropriate intensive care can be given early in the course of admission. This would reduce the morbidity and mortality. Methods: In this retrospective, observational study, details regarding 105 patients including their history, examination, and intra-operative findings, laboratory data, and outcomes were collected. Their MPI score was correlated with the outcomes to identify significant prognosticating factors for poor outcomes. Results: In our study, an MPI score of 29 could predict mortality with a sensitivity of 63% and a specificity of 65% and morbidity with a sensitivity of 48.57% and a specificity of 77%. Conclusion: MPI is a simple and fairly accurate tool in predicting morbidity and mortality among patients with small intestinal perforations.

Keywords

• perforation
• peritonitis
• mannheim peritonitis index