Modified APACHE II scoring and Mannheims peritonitis Index (MPI) in predicting the outcome of patients with peritonitis secondary to hollow viscous perforation

Abstract

The prognosis and outcome of peritonitis depend upon the interaction of several factors, which includes` patient-related factors, disease-specific factors, diagnostic and therapeutic interventions. Categorizing patients into different risk groups would help prognosticate the outcome, select patients for intensive care and determine operative risk, thereby helping to choose the nature of the operative procedure, e.g. damage control vs. definitive procedure. Study population consisted of 80 consecutive patients with peritonitis secondary to hollow viscus perforation which were confirmed on emergency laparotomy. APACHE II score was assigned to all patients. Mean apache II scores in survivors were 7.5±5.3 and in non survivors 19.7±4.7. Of the 72 survivors, with mean of 7.5, 8 patients who died had a mean of 19.5, and again the difference between groups were significant (p< 0.0001). Based on APACHE II scores patients were divided into 3 groups with scores of 20. The number of patients scoring less than 10 was 71(88.8%) of the study group. One patient with less than a score of 10 expired. 5 patients had scores in range of 11-20, 2 survived and 3 expired. 4 patients had scores more than 20 and all 4 patients expired.