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Epidemiology and peculiarities of pediatric multiple organ dysfunction syndrome in New Delhi, India

Praveen Khilnani1, Devajit Sarma, Jerry Zimmerman

  • 1Pediatric Critical Care Services, Institute of Pediatrics, Max Health Care Hospitals Saket, New Delhi, India. pkhilnani@vsnl.com

Intensive Care Medicine
|September 16, 2006
PubMed

Insights

Multiple organ dysfunction syndrome (MODS) in critically ill children from developing countries has unique causes like malaria and dengue. Higher Organ Failure Index (OFI) scores correlate directly with increased mortality risk in these pediatric patients.

Area of Science:

  • Pediatric Critical Care Medicine
  • Epidemiology of Critical Illness
  • Global Health Research

Background:

  • Limited data exists on pediatric multiple organ dysfunction syndrome (MODS) in developing nations.
  • Understanding MODS epidemiology in diverse settings is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the epidemiology and outcomes of MODS in critically ill children in a developing country.
  • To assess the relationship between the Organ Failure Index (OFI) and mortality in this population.

Main Methods:

  • Prospective observational study conducted in a tertiary pediatric intensive care unit.
  • 1722 children aged 1 month to 16 years were included over a 5.5-year period.
  • Data collected on MODS development, antecedents, and outcomes, including OFI scores.

Main Results:

  • 10.6% of patients developed persistent MODS, contributing to 49.2% of ICU deaths.
  • Overall survival for MODS patients was 64%.
  • Significant antecedents included sepsis, falciparum malaria, fulminant hepatic failure, and dengue shock syndrome. Mortality increased with OFI scores (9% for OFI=2 to 100% for OFI>5).

Conclusions:

  • MODS in developing countries has distinct etiologies beyond sepsis, such as malaria and dengue.
  • The Organ Failure Index (OFI) is a strong predictor of mortality in critically ill children with MODS in developing countries.
Abstract

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