Int J Clin Exp Med 2016;9(6):12032-12038 www.ijcem.com /ISSN:1940-5901/IJCEM0023947 Original Article Effect of intraabdominal pressure values and Mannheim Peritonitis Index to prognosis of patients with acute abdomen Hüseyin Pülat 1 , Oktay Karaköse 2 , İsmail Zihni 3 , Kazım Çağlar Özçelik 3 , Hüseyin Eken 4 , Alpaslan Fedai Çalta 5 , Mehmet Fatih Benzin 6 , Abdil Cem İbiş 1 1 General Surgery Department, Trakya University, Turkey; 2 Surgical Oncology Department, Samsun Training and Research Hospital, Turkey; 3 Surgical Oncology Department, Suleyman Demirel University, Turkey; 4 General Sur- gery Department, Erzincan University, Turkey; 5 General Surgery Department, Bandırma State Hospital, Turkey; 6 General Surgery Department, Suleyman Demirel University, Turkey Received January 13, 2016; Accepted May 6, 2016; Epub June 15, 2016; Published June 30, 2016 Abstract: Background: Mannheim Peritonitis Index, that has been evaluated to calculate the prognosis of the pe- ritonitis patients, is a simple and predictive scoring test. The disadvantage is that some of the parameters must be calculated peroperatively. In our studies, in order to by-pass this disadvantage, by modificating the test by the bladder pressure parameters thus creating a new scoring system that’s called Modificated Mannheim Peritonitis Index. Material and method: Seventy-five patients, between the age of 15-89, diagnosed as surgical acute abdomi- nal syndrome and planned to have an emergency operation has been included in the study. Results: It has been found out that the Mannheim Peritonitis Index score of the patients, increases with the length of hospitalitisation. If the test cut-off value is set to 26, the scores above this level shows increased the postoperative complications and mortality rates. Mannheim Peritonitis Index score above 30 are calculated to have a sensitivity of 57%, specificity of 82%, positive predictive value of 25% and negative predictive value of 95% and a 80% accuracy rate for predict- ing the mortality. We also found that the bladder pressure on admission is irrevelant on mortality and complication rates. The prognosis of the patients has a statistically significant relationship with the parameters: Age above 50, organ failure, malignancy, sepsis and exudate with feces. Conclusions: As an addition the goal as changing some of the parameters of Mannheim Peritonitis Index with bladder pressure values and creating a new scoring system with similar predictive abilities has been failed. Keywords: Surgical acute abdomen, bladder pressure, abdominal compartment syndrome, Mannheim Peritonitis Index, prognosis Introduction All of the pathologies which characterized by sudden onset of abdominal pain, signs and symptoms that focuses on the abdominal area and developing due to non-traumatic causes is defined as acute abdominal syndrome [1, 2]. Acute abdomen constutide the majority of sur- gical emergency cases in general surgery clin- ics. Because disease starts suddenly and shows rapid progress in acute abdomen, early diagnosis of acute abdomen and to intervene quickly to patients is very important [2]. Intra-abdominal pressure increases because of reasons such as peritonitis, ileus, a diffuse ascites, intra-abdominal hemorrhage, applica- tion of military anti-shock trousers, large intra- abdominal tumors, laparoscopic surgery, peri- toneal dialysis, abdominal or pelvic trauma [3, 4]. Intraabdominal pressure can be determined by measuring bladder pressure [4]. Bladder pressure measurement is a method used in diagnosis and monitoring of abdominal com- partment syndrome [3]. Scoring systems was developed to determine the prognosis of pa- tients in the surgical infection, peritonitis and intra-abdominal sepsis. Mannheim Peritonitis Index of the proposed scoring systems is quite came to the fore ease of application and effec- tiveness. Mannheim Peritonitis Index is the scoring system which considering demographic data and the etiology of the disease, simple, but a higher prediction rate [5]. In order to eliminate this drawback, we aimed to create a new scoring system by modifying peri- operative parameters in Mannheim Peritonitis