Key result
The APACHE-II score demonstrated higher sensitivity (83% vs 51%) and specificity (94% vs 77%) than the Mannheim Peritonitis Index for predicting mortality in perforation peritonitis.
Why the study?
Studies have conflicted on whether APACHE II or MPI is a better scoring system for prognosticating outcomes in patients with peritonitis.
Does APACHE-II provide better prognostication of outcome compared to MPI in patients with perforation peritonitis?
Observational (n=100)
No
Does APACHE-II provide better prognostication of outcome compared to MPI in patients with perforation peritonitis?
APACHE-II is superior to MPI for prognosticating outcomes in patients with perforation peritonitis, though MPI remains useful in resource-limited settings.
APACHE-II may outperform MPI for mortality prognostication in perforation peritonitis; leaves open need for prospective validation before practice change.
Introduction: Peritonitis presents most commonly due to the localized or generalized infection. Studies have reported APACHE II to be a better system for prognostication of the outcome of patients with peritonitis, while others concluded that MPI provides a more reliable means of risk evaluation. The present study is conducted with the objective to nd out efcacy of MPI in comparison to APACHE II to prognosticate the outcome in patients with perforation peritonitis. Material and methods: This was a prospective hospital based analytical study conducted in department of surgery at Dr. BRAM Hospital, Raipur of Pt. JNMCH Raipur. Total 100 patients with peritonitis fullls the inclusion criteria was included in the study. Both scoring system is applied for the individual patient at admission or within 24 hours. Data was analysed using SPSS version 20.0. Descriptive statistics; frequency, percentage statistical signicance and p value were calculated. Results: The mean age of study subjects was 43.89±15.75 years. Of that (84%) were males. The chief complaint was abdominal pain and not passing atus. The primary outcome shows that one third was died during treatment and rests were discharged. The mean APACHE-II and MPI score among death cases was 14.7 and 25.2. APACHE-II score has sensitivity of 83% and specicity of 94% whereas MPI score has sensitivity of 51% and specicity of 77%. Conclusion: Though MPI did not prove to be as good as APACHE II in this study, there is denitely benet in using the MPI scores in primary and secondary level hospitals where facilities are less and investigations such as blood gas may not be available. They can be used to ascertain a certain extent of the patient's present condition and the prognosis
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Sonker et al. (2022) conducted an observational in perforation peritonitis (n=100). APACHE-II score vs. Mannheim Peritonitis Index (MPI) was evaluated on Mortality during treatment. The APACHE-II score demonstrated higher sensitivity (83% vs 51%) and specificity (94% vs 77%) than the Mannheim Peritonitis Index for predicting mortality in perforation peritonitis.
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