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Mannheim Peritonitis Index (MPI)

Also called MPI, Mannheim index

Intra-operative score of eight risk factors that predicts death from purulent peritonitis.

Exudate

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Formula and scoring

Age >50: 5; female: 5; organ failure: 7; malignancy: 4; pre-op duration >24 h: 4; non-colonic origin: 4; diffuse peritonitis: 6; exudate clear 0 / cloudy-purulent 6 / faecal 12. Range 0–47.

Exam and ward pearls

  • MPI is scored at laparotomy — the exudate and spread of peritonitis are operative findings.
  • Widely validated in Indian perforation-peritonitis series; faecal exudate alone is worth 12 points.

When not to rely on it

  • Mortality figures are from 1980s–90s European cohorts; local mortality depends on case mix and critical-care access.

Source

  1. Linder MM, Wacha H, Feldmann U, et al. [The Mannheim peritonitis index. An instrument for the intraoperative prognosis of peritonitis]. Chirurg. 1987;58(2):84-92. PMID 3568820
  2. Billing A, Fröhlich D, Schildberg FW. Prediction of outcome using the Mannheim peritonitis index in 2003 patients. Br J Surg. 1994;81(2):209-13. doi:10.1002/bjs.1800810217 · PMID 8156338
  3. Ramteke H, Deshpande SG, Bhoyar R. The role of the Mannheim Peritonitis Index for predicting outcomes in patients with perforation peritonitis in a rural hospital in India. Cureus. 2023;15(3):e36620 (Table 1: weights and organ-failure definitions). doi:10.7759/cureus.36620 · PMID 37102001

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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