Evaluation of Mannheim Peritonitis Index and APACHE II Score in Predicting Mortality and Morbidity in Patients with Peritonitis from Hollow Viscus Perforation

Abstract

Peritonitis caused by hollow viscus perforation (HVP) is a life-threatening condition that requires prompt assessment and intervention. Accurate risk stratification tools are crucial in managing these cases effectively, guiding clinical decisions, and allocating resources. This study evaluates the predictive accuracy of two scoring systems, the Mannheim Peritonitis Index (MPI) and the Acute Physiology and Chronic Health Evaluation (APACHE II), in assessing mortality and morbidity in patients with HVP-induced peritonitis. A retrospective cohort analysis of 300 patients was conducted, categorizing them into low, moderate, and high-risk groups based on MPI and APACHE II scores at admission. The primary outcomes were mortality within 30 days and morbidity markers, including ICU admission and length of hospital stay. Results demonstrated that both MPI and APACHE II scores were effective in predicting outcomes, with high-risk patients showing significantly higher mortality and morbidity rates. Receiver Operating Characteristic (ROC) curve analysis yielded an AUC of 0.84 for MPI and 0.87 for APACHE II, indicating slightly higher predictive accuracy for APACHE II. However, the difference was not statistically significant. This study suggests that both scoring systems are valuable for clinical use in peritonitis cases, with MPI offering a targeted approach and APACHE II providing a broader assessment of patient status.