Effect of intraabdominal pressure values and Mannheim Peritonitis Index to prognosis of patients with acute abdomen

Pulat H., Karakose O., ZİHNİ İ., Ozcelik K. C., Eken H., Calta A. F., ...More

INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE, vol.9, no.6, pp.12032-12038, 2016 (SCI-Expanded) identifier identifier


Background: Mannheim Peritonitis Index, that has been evaluated to calculate the prognosis of the peritonitis patients, is a simple and predictive scoring test. The disadvantage is that some of the parameters must be calculated peroperatively. In our studies, in order to by-pass this disadvantage, by modificating the test by the bladder pressure parameters thus creating a new scoring system that's called Modificated Mannheim Peritonitis Index. Material and method: Seventy-five patients, between the age of 15-89, diagnosed as surgical acute abdominal syndrome and planned to have an emergency operation has been included in the study. Results: It has been found out that the Mannheim Peritonitis Index score of the patients, increases with the length of hospitalitisation. If the test cut-off value is set to 26, the scores above this level shows increased the postoperative complications and mortality rates. Mannheim Peritonitis Index score above 30 are calculated to have a sensitivity of 57%, specificity of 82%, positive predictive value of 25% and negative predictive value of 95% and a 80% accuracy rate for predicting the mortality. We also found that the bladder pressure on admission is irrevelant on mortality and complication rates. The prognosis of the patients has a statistically significant relationship with the parameters: Age above 50, organ failure, malignancy, sepsis and exudate with feces. Conclusions: As an addition the goal as changing some of the parameters of Mannheim Peritonitis Index with bladder pressure values and creating a new scoring system with similar predictive abilities has been failed.