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Validation of the multiple organ dysfunction (MOD) score in critically ill medical and surgical patients
Thomas A Buckley1, Charles D Gomersall2, Sarah J Ramsay1
1Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong.
Objective:
To validate the Multiple Organ Dysfunction (MOD) score externally.
Design:
Prospective observational cohort study.
Setting:
Mixed medical/surgical ICU in a tertiary referral university hospital.
Patients And Participants:
Thousand eight hundred and nine patients admitted to ICU for more than 24 h over a 3-year period.
Interventions:
None.
Measurements And Results:
The MOD score was calculated daily for all patients. The criterion validity of the individual organ scores, the maximal MOD score and the change in MOD score were assessed by examining the relationship between increasing scores and ICU mortality. Increased maximal MOD scores and each of the six individual organ scores, and change in MOD scores were associated with increased mortality.
Conclusions:
Maximal and individual organ scores have criterion validity when tested in a different ICU from that in which the scores were derived, indicating that the scoring systems are reproducible. The association of change in MOD score with mortality indicates that the score is responsive. These data, combined with previous data establishing concept and content validity, indicate that the MOD score is a valid measure of multi-organ dysfunction.
Insights
The Multiple Organ Dysfunction (MOD) score effectively predicts ICU mortality. This external validation confirms its reproducibility and responsiveness for assessing multi-organ dysfunction.
Area of Science:
- Critical Care Medicine
- Prognostic Scoring Systems
- Patient Outcomes
Background:
- The Multiple Organ Dysfunction (MOD) score is a tool used to assess the severity of organ dysfunction in critically ill patients.
- External validation is crucial to confirm the generalizability and reliability of prognostic scores across different healthcare settings.
Purpose of the Study:
- To externally validate the Multiple Organ Dysfunction (MOD) score.
- To assess the criterion validity and reproducibility of the MOD score in a new patient cohort.
Main Methods:
- A prospective observational cohort study was conducted in a mixed medical/surgical ICU.
- 1,809 patients admitted to the ICU for over 24 hours were included over a 3-year period.
- Daily MOD scores were calculated, and their association with ICU mortality was analyzed.
Main Results:
- Increased maximal MOD scores and individual organ scores were significantly associated with higher ICU mortality.
- Changes in MOD scores also demonstrated a correlation with increased mortality.
- These findings support the criterion validity of the MOD score components.
Conclusions:
- The MOD score, including maximal and individual organ scores, is reproducible and valid when applied in a different ICU setting.
- The score's responsiveness to changes in patient condition, as indicated by its association with mortality, further supports its utility.
- The MOD score is a reliable measure for assessing multi-organ dysfunction.