🦠 Mannheim Peritonitis Index (MPI)
Predict mortality in secondary peritonitis with the Mannheim Peritonitis Index.
Clinical takeaway
> 29 corresponds to ≈ 59% mortality.
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When to use
Risk-stratify peritonitis to guide source control and monitoring intensity.
How it works
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.
Key points
- > 29 corresponds to ≈ 59% mortality.
- A ≥ 26 dichotomy is also used.
- Integrate with APACHE II and lactate.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
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
Frequently asked 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）