Mannheim Peritonitis Index (MPI) — free guideline decision tool
Predict mortality in secondary peritonitis with the Mannheim Peritonitis Index.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age > 50 y | No (0) |
|---|---|
| Female sex | No (0) |
| Organ failure (renal/pulmonary/shock/intestinal obstruction) | None (0) |
| Malignancy | None (0) |
| Preoperative peritonitis > 24 h | No (0) |
| Origin of sepsis not colonic | Colonic (0) |
| Diffuse (generalized) peritonitis | Localized (0) |
| Character of exudate | Clear (0) |
→MPI0
- Band：0 (range 0–47) → Low (< 21 low ≈ 0–2.3%, 21–29 intermediate ≈ 22%, > 29 high ≈ 59% mortality)
- Action：Low: standard source control and antimicrobials, routine postoperative care
- Organ failure：Renal: creatinine > 177 µmol/L or oliguria; pulmonary: PO₂ < 50 or PCO₂ > 50 mmHg; shock; intestinal obstruction/ileus > 24 h
| Age > 50 y | Yes (5) |
|---|---|
| Female sex | Yes (5) |
| Organ failure (renal/pulmonary/shock/intestinal obstruction) | Present (7) |
| Malignancy | Present (4) |
| Preoperative peritonitis > 24 h | Yes (4) |
| Origin of sepsis not colonic | Non-colonic (4) |
| Diffuse (generalized) peritonitis | Diffuse (6) |
| Character of exudate | Fecal (12) |
→MPI47
- Band：47 (range 0–47) → High (< 21 low ≈ 0–2.3%, 21–29 intermediate ≈ 22%, > 29 high ≈ 59% mortality)
- Action：High risk: aggressive source control (emergency debridement/drainage), critical care, broad-spectrum antibiotics + resuscitation, consider planned relaparotomy/open abdomen
- Organ failure：Renal: creatinine > 177 µmol/L or oliguria; pulmonary: PO₂ < 50 or PCO₂ > 50 mmHg; shock; intestinal obstruction/ileus > 24 h
Common questions
What is Mannheim Peritonitis Index (MPI)?
Predict mortality in secondary peritonitis with the Mannheim Peritonitis Index.
How is Mannheim Peritonitis Index (MPI) calculated? What is the core formula?
Sum 8 factors (age > 50, female, organ failure, malignancy, duration > 24 h, non-colonic origin, diffuse peritonitis, exudate character), range 0–47. < 21 low, 21–29 intermediate, > 29 high.
When is Mannheim Peritonitis Index (MPI) used?
Risk-stratify peritonitis to guide source control and monitoring intensity.
What are the key clinical points for Mannheim Peritonitis Index (MPI)?
> 29 corresponds to ≈ 59% mortality. A ≥ 26 dichotomy is also used. Integrate with APACHE II and lactate.
What are the limits and cautions when using Mannheim Peritonitis Index (MPI)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Mannheim Peritonitis Index (MPI) calculated in practice? Can you show a worked example?
Inputs: Age > 50 y No (0), Female sex No (0), Organ failure (renal/pulmonary/shock/intestinal obstruction) None (0), Malignancy None (0), Preoperative peritonitis > 24 h No (0), Origin of sepsis not colonic Colonic (0), Diffuse (generalized) peritonitis Localized (0), Character of exudate Clear (0) → Result: MPI 0（Band: 0 (range 0–47) → Low (< 21 low ≈ 0–2.3%, 21–29 intermediate ≈ 22%, > 29 high ≈ 59% mortality), Action: Low: standard source control and antimicrobials, routine postoperative care, Organ failure: Renal: creatinine > 177 µmol/L or oliguria; pulmonary: PO₂ < 50 or PCO₂ > 50 mmHg; shock; intestinal obstruction/ileus > 24 h） Inputs: Age > 50 y Yes (5), Female sex Yes (5), Organ failure (renal/pulmonary/shock/intestinal obstruction) Present (7), Malignancy Present (4), Preoperative peritonitis > 24 h Yes (4), Origin of sepsis not colonic Non-colonic (4), Diffuse (generalized) peritonitis Diffuse (6), Character of exudate Fecal (12) → Result: MPI 47（Band: 47 (range 0–47) → High (< 21 low ≈ 0–2.3%, 21–29 intermediate ≈ 22%, > 29 high ≈ 59% mortality), Action: High risk: aggressive source control (emergency debridement/drainage), critical care, broad-spectrum antibiotics + resuscitation, consider planned relaparotomy/open abdomen, Organ failure: Renal: creatinine > 177 µmol/L or oliguria; pulmonary: PO₂ < 50 or PCO₂ > 50 mmHg; shock; intestinal obstruction/ileus > 24 h）
Run Mannheim Peritonitis Index (MPI) now
Predict mortality in secondary peritonitis with the Mannheim Peritonitis Index.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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