Innovative Biostatistic Processing End-Point Quantified Inferential Analysis-A Prognostic Value Indicator of Manheim Peritonitis Index (MPI) in Laparoscopic Surgery

Introduction:The Mannheim Peritonitis Index (MPI) is a useful tool for the evaluation for follow-up of patients who undergone surgical intervention for peritonitis.Generally, a high score is associated with increased mortality and it has not been yet sufficiently evaluated for f laparoscopic interventions.A topic of interest is about the MPI benefits for classic surgery versus laparoscopic surgery.Material and methods: We performed a retrospective, observational, non-randomized study that included 109 subjects with peritonitis, with laparoscopic, emergency approach.As we did not record any deaths in our group, we resorted to innovative biostatistical processing and decided that the severity of the case should be quantified using the total duration of hospitalization, measured in days.Thus, the main "end-points" of the study were the duration of surgery and the total number of hospitalization days.The influence of MPI on the duration of hospitalization was investigated by logistic regression.In order to determine a possible association, we used a simple univariate linear regression model, with the variable dependent being the duration of hospitalization and the independent variable being the MPI.Results: The average recorded value of MPI was 11.04 and the maximum value was 20, and the distribution of the variable was close to the Gaussian distribution.A 1 value increase in the Mannheim score is associated with an approximately 1-day increase in hospital stay for patients operated laparoscopically for the diagnosis of peritonitis, the effect being statistically significant (p <0.0001).The box-plot did not reveal distributional outliers.Conclusions: In addition to its already committed role in the prognosis of mortality in patients with peritonitis operated by open surgery, MPI can also be considered more recently as an evolutionary prognostic factor in the laparoscopic treatment of this type of pathology.The outcome will help surgeons select the cases of peritonitis they intend to operate laparoscopically more carefully, with minimal risks for the patients.There are not enough studies on this topic in the literature, which is why we recommend further research.