220100215, - (2015) Effectiveness of MANNHEIM PERITONITIS INDEX. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Peritonitis due to hollow viscous perforation continues to be one of the most common surgical emergencies to be attended by a surgeon on call duty. This may be due to persistence of the various risk factors among the general population like H.pylori infection, NSAID‘s, enteric fever and several others. This condition most of the times needs an emergency surgical intervention, a scoring system should be able to assess the need, type, and quality of the care required for a particular patient. Realizing the need for a simple accurate scoring system in these conditions this study is undertake to estimate the use of MPI scoring system for predicting the risk about morbidity and mortality for patients with peritonitis because of hollow viscous perforation. Several scoring systems are in place to stratify the patients with peritonitis because of hollow viscous perforation like APS, SIS, APACHE and BOEYS. Utilization of scoring systems would be of great help in salvaging a priceless life of a patient. Our study is aimed at testing the effectiveness of MANNHEIM PERITONITIS INDEX. AIMS AND OBJECTIVES: Aim is to predict the mortality and morbidity for patients with peritonitis because of hollow viscous perforation. Assessing the outcome in these patients is helpful in choosing the modality of post op management in a particular patient. Our study tries to assess the prognostic value of MPI scoring system in patients with peritonitis because of hollow viscous perforation, to assess this as a clinical tool in distinguish the patients based on individual operative possibility. METHODS: 50 patients with hollow viscous perforation admitted in Govt. Stanley Medical College & Hospital, Chennai from January 2014 to August 2014 were enrolled in to my study. Necessary information was collected; MPI score was calculated for every patient and analysis done. RESULTS: The number of post operative complications, duration of ICU and hospital stay proportionately increased with the MPI score. Out of the 8 variables used in this scoring system, duration of pain, intra peritoneal fluid and organ failure on admission carried more significance in predicting the morbidity in the post op period than the other variables. CONCLUSION: There have been several attempts at creating a scoring system to predict mortality and morbidity risk after emergency surgery. Some scoring systems provide a prediction that approximates to the observed mortality rate for a cohort, but none is sufficiently accurate to rely upon when considering an individual patient. This is a validation study of the MANNHEIM PERITONITIS INDEX scoring system for predicting the morbidity and mortality in patients with peritonitis due to hollow viscous perforation. The results of this study proves that MPI scoring system is a simple and effective tool for assessing this group of patients, and can be used as a guiding tool to decide on the management of the patient after the definitive procedure is done. Among the various variables of the scoring system duration of pain, organ failure on presentation and presence of feculent exudates had a significant hand in predicting the eventual outcome of the patient.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Peritonitis ; scoring systems ; outcome predictors ; morbidity.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 22 Oct 2017 02:57
Last Modified: 22 Oct 2017 02:57
URI: http://repository-tnmgrmu.ac.in/id/eprint/3801

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