Mannheim Peritonitis Index (MPI)
Predicts mortality risk in patients with peritonitis to guide surgical aggressiveness and ICU triage
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Care settings
- Emergency department, ICU, Inpatient
When it activates
Scribeable activates a calculator from the encounter. The Mannheim Peritonitis Index (MPI) can activate when the transcript or pasted chart context documents any of these:
- Peritonitis management
- Perforated viscus management
- Intra-abdominal infection severity
- Surgical prognosis in peritonitis
- ICU triage for surgical abdomen
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: K65.
Note-type scope: it activates on notes whose subject resolves to gi, critical care, hospital medicine, perioperative, emergency medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
8 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Age ≥50 years | age | ||
| Patient is female | history | ||
| Organ failure present | history | ||
| Malignancy present | history | ||
| Duration of peritonitis >24 hours preoperatively | history | ||
| Origin of sepsis is NOT colonic | history | ||
| Diffuse generalized peritonitis (vs localized) | exam | ||
| Type of exudate: clear, cloudy/purulent, or fecal | exam |
Scoring
Age ≥50: +5. Female: +5. Organ failure: +7. Malignancy: +4. Duration >24h: +4. Origin not colonic: +4. Diffuse peritonitis: +6. Exudate: clear=0, cloudy=+6, fecal=+12. Total 0-47.
5×Age≥50 Age ≥50 years + 5×Female Patient is female + 7×Organ failure Organ failure present + 4×Malignancy Malignancy present + 4×>24h Duration of peritonitis >24 hours preoperatively + 4×Non-colonic origin Origin of sepsis is NOT colonic + 6×Diffuse peritonitis Diffuse generalized peritonitis (vs localized) + Exudate Type of exudate: clear, cloudy/purulent, or fecal (clear=0, cloudy=+6, fecal=+12)
Interpretation
MPI <21: Low mortality (~2.3%). MPI 21-29: Moderate mortality (~22.5%) — ICU monitoring advisable. MPI ≥30: High mortality (~59.1%) — aggressive ICU care, consider planned re-laparotomy.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Wacha H & Linder MM 1983.
- Linder MM et al. The Mannheim Peritonitis Index: an instrument for intraoperative prognosis of peritonitisLinder et al. (Mannheim) 1983 · 1983 · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the Mannheim Peritonitis Index (MPI) (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. A stated Mannheim Peritonitis Index (MPI) value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.
Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.
See it activate on your own encounter
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