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Multiple organ failure in septic patients.

E Bilevicius1, D Dragosavac, S Dragosavac

  • 1Department of Surgery, Intensive Care Unit, UNICAMP, Campinas, SP, Brazil. bilevicius@yahoo.com

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|August 17, 2001
PubMed
Summary

Multiple organ failure (MOF) in intensive care units (ICUs) is common in sepsis patients, with mortality increasing with the number of failing organs and patient age. High APACHE II scores also indicate a worse prognosis for sepsis-induced MOF.

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Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pathophysiology

Background:

  • Multiple organ failure (MOF) is a leading cause of mortality in intensive care units (ICUs), particularly among septic patients.
  • Factors influencing MOF prognosis include the number and type of failing organs, patient age, comorbidities, and resuscitation adequacy.

Purpose of the Study:

  • To investigate the incidence of sepsis and MOF in a university teaching hospital ICU.
  • To analyze the distribution of MOF across organ systems and its correlation with mortality.
  • To identify common bacterial causes of sepsis and evaluate the relationship between mortality, age, and organ failure severity.

Main Methods:

  • Retrospective evaluation of 249 ICU patients over a 4-month period in 1999.
  • Sepsis diagnosed using ACCS/SCCM criteria; MOF diagnosed using Marshall and Meakins criteria within the first five days.

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  • APACHE II scores calculated on admission; statistical analysis using the Mann-Whitney test (p<0.05 considered significant).

    • Main Results:

    • Sepsis incidence was 22% (54/249 patients), with a 56% mortality rate (30/54).
    • Mortality significantly increased with the number of failing organs: 18% for one organ, 52% for 2-3 organs, and 88% for 4+ organs.
    • Higher mortality was observed in older patients (>61 years: 68%) and those with higher APACHE II scores (non-survivors: 42 +/- 26 vs. survivors: 21 +/- 18, p<0.001).
    • Pseudomonas aeruginosa and multiresistant Acinetobacter baumanii were among the most frequent bacterial causes.

    Conclusions:

    • MOF due to sepsis is a frequent and severe complication in ICUs.
    • Mortality is strongly associated with the number of failing organs, patient age, and elevated APACHE II scores.
    • Understanding these factors is crucial for improving outcomes in septic patients with MOF.