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Multiorgan failure in critically ill patients.

G E Darling1, J H Duff, R A Mustard

  • 1Department of Surgery, University of Western Ontario, London.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|May 1, 1988
PubMed
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Multiorgan failure (MOF) affects 100 intensive care unit patients, with a high 78% death rate. Sepsis, shock, and surgery are common causes, highlighting critical care challenges.

Area of Science:

  • Critical Care Medicine
  • Internal Medicine
  • Pathophysiology

Background:

  • Multiorgan failure (MOF) is a severe complication in intensive care units (ICUs).
  • Understanding MOF's incidence, causes, and risk factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the incidence, initiating factors, risk factors, and outcomes of multiorgan failure in a medical-surgical ICU population.
  • To identify the most commonly affected organ systems in patients with MOF.

Main Methods:

  • Prospective study of 1136 consecutive admissions to two medical-surgical ICUs.
  • Defined MOF as failure of more than two organ systems.
  • Analyzed initiating illnesses, risk factors, duration of stay, and mortality.

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Main Results:

  • 100 patients (8.8%) developed MOF, with an average ICU stay of 13.4 days.
  • Overall mortality for MOF patients was 78%, compared to 12.8% for others.
  • Common initiating factors included sepsis, surgery, trauma, and cardiogenic shock; risk factors included shock, sepsis, surgery, pre-existing disease, and age >65.
  • Central nervous, cardiovascular, and respiratory systems were most frequently affected.

Conclusions:

  • MOF is associated with significantly higher mortality in ICU patients.
  • Sepsis, shock, and surgery are key contributors, necessitating targeted interventions.
  • Early identification and management of risk factors are vital for critical care.