Related Experiment Videos
Outcome of pediatric patients with multiple organ system failure
Abstract:
The association of multiple organ system failure (MOSF) with mortality was investigated in 831 consecutive admissions to a pediatric ICU. The incidence of MOSF (at least two organ system failures, OSF) was 27%. Of the 62 nonsurvivors, 60 (97%) had MOSF. The mortality for patients with MOSF was 54%, compared to a mortality of 0.3% for patients without MOSF. Mortality increased directly with increasing number of OSF (p less than .0001). The mortality was 1% for one OSF, 11% for two OSF, 50% for three OSF, and 75% for four OSF. Comparison of these results with data from adult ICU patients indicates that the mortality and clinical course of MOSF in children is distinct from adults. MOSF is significantly associated with mortality in pediatric patients; however, it is not sufficiently discriminating to determine continuation or withdrawal of ICU support.
Insights
Multiple organ system failure (MOSF) significantly increases mortality risk in pediatric intensive care unit (PICU) patients. While MOSF is a strong predictor, it may not be sufficient for making critical care decisions.
Area of Science:
- Pediatric critical care medicine
- Intensive care unit (ICU) outcomes
- Epidemiology of critical illness
Background:
- Multiple organ system failure (MOSF) is a critical condition in pediatric intensive care units (PICUs).
- Understanding the association between MOSF and mortality is crucial for patient management.
- Previous studies have primarily focused on adult populations, necessitating pediatric-specific data.
Purpose of the Study:
- To investigate the incidence and mortality associated with multiple organ system failure (MOSF) in a pediatric intensive care unit (PICU).
- To determine the relationship between the number of organ system failures (OSF) and mortality rates in pediatric patients.
- To compare the clinical course and outcomes of MOSF in children versus adults.
Main Methods:
- Retrospective analysis of 831 consecutive admissions to a pediatric ICU.
- Defined MOSF as at least two organ system failures (OSF).
- Calculated incidence of MOSF and associated mortality rates, correlating mortality with the number of OSF.
Main Results:
- The incidence of MOSF was 27% among pediatric ICU admissions.
- Patients with MOSF had a significantly higher mortality rate (54%) compared to those without (0.3%).
- Mortality increased progressively with the number of OSF: 1% (1 OSF), 11% (2 OSF), 50% (3 OSF), and 75% (4 OSF).
- Ninety-seven percent of non-survivors experienced MOSF.
- Pediatric MOSF outcomes appear distinct from those observed in adult ICU patients.
Conclusions:
- Multiple organ system failure (MOSF) is a significant predictor of mortality in pediatric intensive care.
- The number of organ system failures (OSF) directly correlates with increased mortality risk in children.
- While MOSF is a critical indicator, it may not be definitive for guiding the continuation or withdrawal of ICU support.