Evaluation of Mannheim Peritonitis Index in Predicting Morbidity and Mortality in Patients with Peritonitis Due to Hollow Viscus Perforation: A Prospective Observational Study

Introduction: Peritonitis occurring due to hollow viscus perforation is considered as a life-threatening surgical emergency associated with significant Morbidity and Mortality. Early recognition of high-risk patients is necessary for timely intervention and optimal use of available limited resources. The Prevailing Mannheim Peritonitis Index (MPI) is considered as a disease-specific scoring system to predict the clinical outcomes in patients with peritonitis using clinical parameters and intra-operative details. Materials and Methods: This cross sectional study was conducted in a tertiary care set up in Western Tamil Nadu. The study participants included adult patients who presented with peritonitis secondary to hollow viscus perforation which was confirmed intra-operatively. MPI scores were calculated for all the study participants and were categorized as three groups (<21, 21–29, and >29. Results: A total of 131 study participants were included in the study. The mean age was 53.49 ± 14.26 years. The mean MPI score observed was 21.36 ± 6.36. Around 42% of participants had any one morbidity. Mortality was observed in 3.1% of the study population. As the MPI scores increased, significantly higher rates of renal complications, ICU admission, prolonged hospital stay, and overall morbidity (p < 0.05) were observed. MPI demonstrated excellent predictive accuracy for mortality (AUC 0.978) and moderate accuracy for morbidity (AUC 0.704). Conclusion: The Mannheim Peritonitis Index is a simple, reliable, and cost effective prognostic tool in predicting morbidity and mortality among patients diagnosed with peritonitis due to hollow viscus perforation. The ease of application and strong predictive accuracy makes this scele as a valuable tool in predicting the Outcome, particularly in resource-limited settings for early risk stratification and management planning.