COMPARATIVE STUDY BETWEEN MPI & APACHE II TO PREDICT OUTCOME IN PATIENTS OF INTESTINAL PERFORATION.

DR.VISHAL SONAWANE; DR. VISHNUKUMAR PATEL; DR. PRIYANK SHARMA

Volume : VIII, Issue : V, May - 2019

COMPARATIVE STUDY BETWEEN MPI & APACHE II TO PREDICT OUTCOME IN PATIENTS OF INTESTINAL PERFORATION.

Dr. Vishal Sonawane, Dr. Vishnukumar Patel, Dr. Priyank Sharma

Abstract :

INTRODUCTION– Peritonitis due to hollow viscous perforation continues to be the common surgical emergency. Perforation of any part of the intestine is a life threatening condition, which is most commonly managed by general surgeons. About 80% of cases of secondary peritonitis in large hospitals account for perforated peritonitis. Many scoring systems have been designed for assessing the severity of perforation peritonitis like acute physiology and chronic health evaluation (APACHE II) score, Mannheim peritonitis index (MPI), POSSUM score, simplified acute physiology score (SAPS), sepsis severity score (SSS),Ranson score ,Imrite score. AIMS & OBJECTIVES– To find the best scoring system to predict outcome amongst the scoring systems. METHODOLOGY– Carried out in 100 cases in 1year duration. After detailed history & investigations , patients were managed .Post op follow up was done & data was recorded. Individual score for each patient was calculated and scores were compared. RESULT– Most of the patients were from 16 to 25 years of age group followed by 26 to 35 years.Ileal perforation was most common among the all intestinal perforation followed by appendicular perforation .Diagnostic Accuracy of MPI, APACHE II Score was 52% & 98%respectively. CONCLUSION– APACHE II score is the best scoring system for assessing the severity of acute intestinal perforation peritonitis in comparison with MPI score. Strict vigilance and prompt correction of the validated factors can improve the general condition of the patient and decrease the mortality