[The Mannheim Peritonitis Index cannot be routinely used to guide surgical decision-making for peritonitis].

OBJECTIVE

To evaluate the evidence base of the Mannheim Peritonitis Index (MPI) for choice of relaparotomy (programmed vs on-demand) in severe peritonitis.

MATERIAL AND

METHODS

The study was carried out in 3 stages.

UNLABELLED: 1. MPI-based assessment of evidence base of national guidelines «Peritonitis» regarding the choice of relaparotomy (programmed vs on-demand).

UNLABELLED: 2. Statements and recommendations of current foreign guidelines on MPI-based choice of tactics for peritonitis.

UNLABELLED: 3. Systematic review of evidence base of studies that used MPI to determine surgical tactics.

RESULTS

The studies listed in national guidelines do not provide evidence of feasibility of MPI as a tool for determining tactics. This index is not mentioned in 3 out of 7 foreign recommendations on abdominal surgical infection. In other recommendations with moderate level of recommendations and low level of evidence, MPI is indicated as a tool for predicting mortality. In 7 retrospective studies not included in recommendations, there was no evidence for advisability of MPI to determine surgical tactics.

CONCLUSION

There is currently no evidence base for MPI in choosing programmed or on-demand relaparotomy in case of severe peritonitis. Further high-evidence studies are required to find significant criteria.