A Prospective Study of Mannheim Peritonitis Index as a Prognostic Scale in the Analysis of Outcome in Hollow Viscus Perforation

Objectives: The present study was to evaluate the Mannheim Peritonitis Index (MPI) score for predicting the outcome in patients with peritonitis due to hollow viscus perforation of any aetiology and to identify the key prognostic factors within the MPI that significantly impact patient outcomes and assess their individual contributions to the overall score. Methods: Patients were evaluated for hollow viscous perforation primarily by imaging studies and also intraoperative evidence of hollow viscous perforation were considered. Patients were evaluated keeping in mind the MPI. Organ failure was assessed based on the criteria. Exudate was collected by a syringe and transferred to a clear test tube to evaluate whether it is clear, cloudy or faecal in nature. Patients were scored from the data available preoperatively and from intraoperative findings according to MPI. Patients were followed up to the time of discharge for the final outcome which include- mortality, duration of stay, and post operative complications such as – wound dehiscence, post op infections, haemorrhage, pulmonary complications etc. Results were analysed with the MPI scoring system. Results: Out of 50 patients, the highest proportion of patients (42.0%) falls within the 21-40 age group, followed by 40.0% in the 41-60 age group. The age group 61-80 has 18.0% of the patients. The female participants comprise 56% of the study population, with a count of 28 individuals. In contrast, the male participants make up 44% of the study population, accounting for 22 individuals.14 participants (28.0%) had a preoperative MPI score in the range of 0-10. In the 10-20 score range, there are 11 participants (22.0%). The 20-30 score range includes 15 participants, making up 30.0% of the study population. This is the largest group, indicating a significant portion of patients with high severity of peritonitis. 10 participants (20.0%) had a preoperative MPI score in the range of 30-40. Conclusions: MPI is a reliable and practical tool for assessing the severity of peritonitis and the risk of mortality and morbidity in these patients. The study showed a clear correlation between higher MPI scores and increased postoperative complications, mortality rates, and prolonged hospital stays. The application of MPI in clinical settings can enhance decision-making processes, enabling healthcare providers to better stratify patients based on their risk profiles and optimize treatment plans accordingly. Early intervention and targeted therapeutic strategies for patients with higher MPI scores could potentially improve survival rates and reduce complications.