Validation Of Mannheim Peritonitis Index (A Nigerian Study)

Abstract

Peritonitis is a serious intra-abdominal infection with poor prognosis despite
application of aggressive surgical techniques like laparostomy, on-demand reoperations,
and irrigations with/without antibiotics. There is need to categorise
patients to select those who will benefit from these aggressive surgical techniques
and to help compare results from different centers. We studied and assessed the
Mannheim Peritonitis Index as a reliable and achievable technique in our
environment. Sixty-seven consecutive patients with generalized peritonitis were
studied. The clinical data and Mannheim Peritonitis Index score for each patient
was collated manually after surgery. The Mannheim Peritonitis Index was graded
into 3 categories: I = MPI < 20, II = MPI 20-29, III = MPI > 30. These were
related to mortality; and length of in-hospital stay was used as a test of morbidity
for survivors. The mean MPI score for non-survivors was 30.6 and survivors 19.7.
There was 92.3% mortality in MPI >30. MPI score of 25 gave the highest degree
of accuracy and should be used as a cut-off mark for assessment of poor prognosis
in our environment. The Mannheim Peritonitis Index (MPI) is an easy and
reliable scoring system that can be used in our environment. The score of 25 is an
acceptable cut-off above which we should expect severe peritonitis.

Keywords: Mannheim, Peritonitis, mortality, prognosis

Ebonyi Medical Journal Vol. 6 (1) 2007 pp. 3-8