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RESEARCH PRODUCT

Mannheim Peritonitis Index (MPI) and elderly population: prognostic evaluation in acute secondary peritonitis

S CampanellaGiuseppe SalamoneGaspare GulottaGiovanni GuercioG AugelloN FalcoL LicariRoberta Tutino

subject

Malemedicine.medical_specialtyMultivariate analysisPrognosiPerforation (oil well)PopulationPeritonitisPeritonitis030230 surgeryLower riskSeverity of Illness IndexScore system03 medical and health sciencesElderly0302 clinical medicineInternal medicineSeverity of illnessmedicineHumansMortalityEvaluationeducationAgedRetrospective StudiesAcute secondary peritonitiAged 80 and overAcute secondary peritonitis; Elderly; Evaluation; High mortality risk; Mannheim Peritonitis Index (MPI); Mortality; Perforative peritonitis; Prognosis; Score systems; SurgeryMannheim Peritonitis Index (MPI)education.field_of_studyPerforative peritonitibusiness.industryMortality rateRetrospective cohort studyMiddle AgedPrognosismedicine.diseaseSurgeryHigh mortality riskIntestinal PerforationAcute DiseaseOriginal ArticleFemaleSurgery030211 gastroenterology & hepatologybusiness

description

Introduction. Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people. Patients and methods. Retrospective study on 104 patients admitted and operated for “Acute Secondary Peritonitis due to visceral perforation”. MPI was scored. In our study we want to demonstrate efficacy of MPI and the possibility to consider older age an independent prognostic factor. Results. Mortality was 25.96%. Greatest sensitivity and specificity for the MPI score as a predictor of mortality was at the score of 20. MPI score of 22. Patients with MPI score 17-21 had 0.46 times lower risk of mortality compared to patients with MPI score >21. In the group of patients with MPI score of >20 the mortality rate was 48.5% for patients older than 80 years old and 12.1% for younger patients (p < 0.005); in the group with MPI score of < 20 mortality rate was respectively 8.4% and 1.4% (p < 0.005). Discussion and conclusions. Data confirm the accuracy of the test. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis.

https://doi.org/10.11138/gchir/2016.37.6.243