THE MANNHEIM PERITONITIS INDEX: A PROGNOSTIC SCORING SYSTEM FOR IN-HOSPITAL MORTALITY IN PERITONITIS SECONDARY TO HOLLOW VISCUS PERFORATION

Abstract

Objective: To investigate in-hospital mortality rates among different Mannheim Peritonitis Index (MPI) score groups in patients who underwent emergency laparotomy due to hollow viscus perforation.

Methods: We enrolled 78 patients presenting with hollow viscus perforation who underwent emergency exploratory laparotomy at a tertiary care hospital. We recorded demographic details, comorbidities, MPI scores, and in-hospital outcomes. Participants were grouped according to MPI score (≤14, 15–25, ≥25), and chi-square test was used to assess the association with in-hospital mortality.

Results: The in-hospital mortality rate was 44.9%. Most deaths occurred in patients with MPI scores ≤14 (62.1%), followed by those with scores between 15 and 25 (46.7%), while only 15.8% of deaths occurred in the >25 group. Among survivors, 84.2% had MPI scores >25. We found no significant association between mortality and age, sex, or common comorbidities. However, MPI score was significantly associated with mortality (p = 0.01), though the pattern observed differed from typical MPI performance.

Conclusion: Our findings show that the MPI did not consistently predict mortality in this cohort. The unexpectedly high mortality in lower MPI groups suggests the need to re-examine the tool’s local applicability. Further prospective research should explore additional clinical and system-level factors that may influence patient outcomes in similar settings.