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A COMPARATIVE STUDY BETWEEN APACHE II SCORING AND MANNHEIM PERITONITIS INDEX TO ASSESS PROGNOSIS IN PERFORATION PERITONITIS

Nikhil Gupta, Dr, Himanshu Agrawal, Dr, Arun K Gupta, Dr, Dipankar Naskar, Dr, C K Durga, Dr. PGIMER Dr RML Hospital, Delhi

Introduction: Peritonitis is the inflammation of the serous membrane that lines the abdominal cavity and the organ contained therein and is one of the most common infections, and an important problem that a surgeon has to face. Reproducible scoring system that allows a surgeon to determine the severity of intra-abdominal infections are essential to prognosticate the patient. This study was done to compare APACHE II scoring and MPI score to assess prognosis in perforation peritonitis.

Methods: All patients admitted with hollow viscus perforation from 1st November 2015 till 31st March 2017 was included in the study. It was a cross sectional observational study. APACHE II and Mannheim Peritonitis Index (MPI) scoring systems were calculated in all the patients in order to assess their individual risk of morbidity and mortality. The outcome variables were studied postoperatively –

Post-operative wound infection, wound dehiscence, Anastomotic leak, Respiratory complications, Duration of Hospital stay, need of ventilator support and Mortality. The inferences were drawn with the use of appropriate tests of significance.

Results: The study comprised of 63 patients. Neither APACHE II nor MPI could predict postoperative wound infection. The mean APACHE II score of 63 subjects included in the study was 11.2±8.1 with range of 0 to 35 and the mean MPI score of 63 subjects included in the study was 26.9±7.2 with range of 6 to 39.APACHE II was able to predict post-operative respiratory complications, post-operative need for ventilatory support, hospital stay duration and Mortality while MPI was able to predict post-operative wound dehiscence, post-operative respiratory complications, post-operative need for ventilatory support and Mortality. Neither APACHE II nor MPI could predict postoperative anastomotic leak and postoperative wound infection.

Conclusion: Mannheim Peritonitis index is a useful and simple method to determine outcome in patients with peritonitis. MPI is comparable to APACHE II in assessing the prognosis in perforation peritonitis and can well be used in emergency setting in place of APACHE II scoring when time is a definite constraint.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 84732

Program Number: P074

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

185

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