Validation Of Mannheim Peritonitis Index (A Nigerian Study)

Peritonitis is a serious intra-abdominal infection with poor prognosis despite application of aggressive surgical techniques like laparostomy, on-demand reoperations, and irrigations with/without antibiotics. There is need to categorise patients to select those who will benefit from these aggressive surgical techniques and to help compare results from different centers. We studied and assessed the Mannheim Peritonitis Index as a reliable and achievable technique in our environment. Sixty-seven consecutive patients with generalized peritonitis were studied. The clinical data and Mannheim Peritonitis Index score for each patient was collated manually after surgery. The Mannheim Peritonitis Index was graded into 3 categories: I = MPI < 20, II = MPI 20-29, III = MPI > 30. These were related to mortality; and length of in-hospital stay was used as a test of morbidity for survivors. The mean MPI score for non-survivors was 30.6 and survivors 19.7. There was 92.3% mortality in MPI >30. MPI score of 25 gave the highest degree of accuracy and should be used as a cut-off mark for assessment of poor prognosis in our environment. The Mannheim Peritonitis Index (MPI) is an easy and reliable scoring system that can be used in our environment. The score of 25 is an acceptable cut-off above which we should expect severe peritonitis. Keywords: Mannheim, Peritonitis, mortality, prognosis Ebonyi Medical Journal Vol. 6 (1) 2007 pp. 3-8