PROGNOSTIC VALUE FOR MORTALITY OF THE MANNHEIM PERITONITIS INDEX IN PATIENTS WITH GASTRIC AND DUODENAL PERFORATION TREATED SURGICALLY AT CAN THO CENTRAL GENERAL HOSPITAL
Main Article Content
Abstract
Background: Peritonitis from gastric and duodenal perforation is a life-threatening condition requiring prompt diagnosis to improve outcomes. The Mannheim Peritonitis Index (MPI) is a widely used tool to evaluate peritonitis severity, predict survival, and guide treatment decisions.
Objectives: To assess the prognostic value of the Mannheim Peritonitis Index in predicting mortality among patients with gastric and duodenal perforation peritonitis undergoing surgery. Materials and Methods: A prospective study was conducted on 117 patients treated surgically for gastric and duodenal perforation peritonitis at Can Tho Central General Hospital from April 2023 to May 2024. The MPI was used to assess mortality risk. Results: The mean patient age was 64.79 ± 15.7 years, with a male-to-female ratio of 2.5:1. The mean MPI score was 23.3 ± 5.4. MPI scores < 21 were observed in 16.2% of cases, 21–29 in 69.2%, and > 29 in 14.5%. Overall mortality was 17.1% (20/117). Mortality rates were 0%, 8.6%, and 76.5% across the MPI groups (p < 0.001). The MPI cutoff score of 29 demonstrated 80% sensitivity and 96% specificity for mortality prediction. Factors associated with higher mortality included age > 50, female sex, preoperative organ failure, and peritonitis duration > 24 hours. Conclusions: The Mannheim Peritonitis Index effectively predicts mortality in gastric and duodenal perforation peritonitis, with higher scores indicating increased risk of death.
Keywords
peritonitis, gastric and duodenal perforation, Mannheim Peritonitis Index
Article Details
References
2. Bosscha K., et al. Prognostic scoring systems to predict outcome in peritonitis and intraabdominal sepsis. Br J Surg. 1997. 84 (11), 1532-4.
3. Kologlu M., et al. Validation of MPI and PIA II in two different groups of patients with secondary peritonitis. Hepatogastroenterology. 2001. 48 (37), 147-51.
4. Muralidhar V.A., et al. Efficacy of Mannheim Peritonitis Index (MPI) Score in Patients with
Secondary Peritonitis. J Clin Diagn Res. 2014. 8 (12), Nc01-3, DOI:
10.7860/jcdr/2014/8609.5229.
5. Velde G., Ismail W.,Thorsen K. Perforated peptic ulcer. Br J Surg. 2024. 111 (9), DOI:
10.1093/bjs/znae224.
6. Bupicha J.A., Gebresellassie H.W.,Alemayehu A. Pattern and outcome of perforated peptic ulcer disease patient in four teaching hospitals in Addis Ababa, Ethiopia: a prospective cohort multicenter study. BMC Surg. 2020. 20 (1), 135, DOI: 10.1186/s12893-020-00796-7.
7. Gaurav K., et al. Effectiveness of Mannheim's Peritonitis Index in Patients With Peritonitis Secondary to Hollow Viscus Perforation in a Tertiary Care Hospital in Jharkhand, India. Cureus. 2024. 16 (5), e59631, DOI: 10.7759/cureus.59631.
8. Nguyễn Văn Hải,Trần Quốc Hưng. Tỷ lệ tử vong của viêm phúc mạc thứ phát và giá trị tiên lượng kết quả điều trị của chỉ số Mannheim. Y học Thành phố Hồ Chí Minh. 2014. 18 (1), 43 - 50.
9. Qureshi A.M., et al. Predictive power of Mannheim Peritonitis Index. J Coll Physicians Surg Pak. 2005. 15 (11), 693-6.
10. Shakya V.C., et al. Evaluation of Mannheim's Peritonitis Index in Prediction of Mortality in Patients with Non-traumatic Hollow Viscus Perforation Peritonitis. J Nepal Health Res Counc. 2021. 19 (1), 179-184, DOI: 10.33314/jnhrc.v19i1.3258.
11. Yoshiko K., et al. Study of Mannheim Peritonitis Index to Predict Outcome of Patients with Peritonitis. Jpn J Gastroenterol Surg. 2004. 37, 7 - 13.
12. Notash A.Y., et al. Evaluation of Mannheim peritonitis index and multiple organ failure score in
patients with peritonitis. Indian J Gastroenterol. 2005. 24 (5), 197-200.