Comparison of Mannheim Peritonitis Index and Acute Physiology and Chronic Health Evaluation II Scores in Predicting Prognosis of Perforation Peritonitis

Background: Perforation peritonitis is a life-threatening surgical emergency with considerable morbidity and mortality. Scoring systems like the Mannheim Peritonitis Index (MPI) and Acute Physiology and Chronic Health Evaluation II (APACHE II) help in risk stratification and guide perioperative care. This study compares the prognostic utility of these scores in predicting outcomes. Materials and Methods: A prospective observational study on 50 patients with perforation peritonitis undergoing laparotomy was conducted. MPI and APACHE II scores were calculated at admission. Clinical course, intensive care unit (ICU) need, complications, and mortality were recorded. Statistical correlations were drawn between scores and outcomes. Results: The overall mortality was 14%. MPI >26 and APACHE II >15 correlated with poor prognosis. MPI had a sensitivity of 85.7% and specificity of 81.4%, while APACHE II showed 71.4% and 84.8%, respectively. Both scores were associated with ICU need and longer hospital stays. Conclusion: MPI and APACHE II are valuable tools in assessing the prognosis of perforation peritonitis. MPI is simpler and effective intraoperatively, while APACHE II may complement it by incorporating systemic parameters.