Evaluation of Various Scoring Systems in Predicting the Outcome in Patients of Perforation Peritonitis

Aim & Objectives: Prospective study to evaluate the mortality prediction in patients with perforation peritonitis using APACHE II, SAPS II, MODS, SOFA and MPI scoring systems. Material and Methods: One hundred patients of hollow viscus perforation peritonitis, from October 2012 – June 2014, were evaluated preoperatively using above mentioned scores and outcome noted in terms of mortality; thereafter, accuracy of the five systems in predicting mortality evaluated. Results: Of the hundred 100 patients, 31 died. Higher age, late presentation, female gender and colonic perforation carried higher mortality; ARDS was the most common complication. It was observed that higher the score, higher was the mortality. More so, APACHE II scores 16-25, SAPS II 40-59, MPI 22-29, MODS 5-8 and SOFA 7-12 correlated significantly (p<0.5) with the predicted outcome. Conclusion: Among the 5 scoring systems, APACHE II, SAPS II & MPI showed less observed mortality rate than predicted percentage at lower scores and higher observed mortality rate than predicted percentage at higher scores; whereas MODS and SOFA showed a much higher observed rate as compared to predicted rate, overall. In all the scoring systems there was a linear increase in death rate with increase in scores.