Study of Mannheim Peritonitis Index to Predict Outcome of Patients with Peritonitis

Yoshiko Kusumoto, Masayuki Nakagawa, Akihiko Watanabe, Hirofumi Ishikawa, Teruyuki Sakaguchi, Takatsugu Yamada, Kenichi Ootsuki, Tomoyo Yokotani and Saburo Hongo

Department of Surgery, Nara Prefectural Nara Hospital

Purpose: We evaluated the reliability of the Mannheim Peritonitis Index (MPI) in predicting the outcome of patients with peritonitis. Method: Subjects were 108 patients operated on for intraabdominal infection and excluded subjects with appendicitis. Results: Overall mortality was 5.3% in men and 15.2% in women, with death occurring only in patients older than 50 years. A comparison of MPI and mortality showed patients with a MPI score of 26 or less to have mortality of 3.8%, whereas those with a score exceeding 26 had mortality of 41.0%. Establishing the cutoff point at 26 on the MPI, resulted in sensitivity of 77.7%, specificity of 97.9%, and accuracy of 88.8%. We also evaluated the revised MPI added the score of renal failure to MPI. The revised MPI was superior to MPI, resulted in sensitivity of 88.8%, specificity of 93.9%, and accuracy of 92.6%. Conclusion: MPI is a simple, useful prognostic index for assessing the severity of peritonitis without the need for extensive laboratory data. The reliability of the index may be improved by including complications associated with multiple organ failure or severe chronic health problems.

Key words
Mannheim Peritonitis Index, peritonitis, score, prognostic factor

Reprint requests
Yoshiko Kusumoto Department of Surgery, Nara Prefectural Nara Hospital
1-30-1 Hiramatsu Nara, 631-0846 JAPAN

Accepted
July 23, 2003

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