Predicting the Surgical Outcome in Patients with Peritonitis Using Mannheim Peritonitis Index (MPI): A Prospective Study

Abstract

Background: Peritonitis constitutes a critical surgical emergency characterized by substantial morbidity and mortality rates. The Mannheim Peritonitis Index (MPI) represents a validated prognostic scoring methodology utilized for outcome prediction in patients requiring surgical intervention for peritonitis.

Objectives: To assess the clinical efficacy of MPI in forecasting postoperative complications and mortality among peritonitis patients in a tertiary hospital in Lucknow..

Methods: This prospective observational investigation was executed at the Integral Institute of Medical Sciences and Research, Lucknow, spanning January 2023 through June 2024. Sixty patients diagnosed with peritonitis requiring exploratory laparotomy were enrolled. MPI scores were determined intraoperatively utilizing eight established risk parameters. Patients were stratified into low (<21), moderate (21–29) and high (>29) risk categories. Postoperative outcomes, encompassing complications and mortality, were evaluated relative to MPI scores employing appropriate statistical methodologies.

Results: The majority of patients (88.3%) were classified within the moderate-risk category. Respiratory and renal complications demonstrated significantly elevated incidence within the high MPI group (p < 0.05). Mortality reached 100% in patients with MPI >29, 5.7% in the moderate group and 0% in the low-risk category. Elevated MPI scores correlated with decreased blood pressure, diminished urine output, increased creatinine levels and hypoxemia.

Conclusion: MPI represents a dependable and practical scoring methodology for predicting morbidity and mortality in peritonitis. It facilitates early risk stratification and enhanced clinical decision-making, particularly in resource-constrained environments.