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Multiple system organ failure. The role of uncontrolled infection
Abstract:
Multiple system organ failure (MSOF) remains a principal cause of death after major operative procedures and/or severe trauma. We studied multiple parameters in 553 consecutive emergency surgical patients to determine the incidence of MSOF, the predisposing factors to MSOF, and the sequelae of MSOF. Thirty-eight patients had MSOF; mortality was 74% for these patients. Evaluation of multiple factors demonstrated that (1) MSOF is primarily due to infection, (2) the temporal sequence of organ failure is lung, liver, gastric mucosa, and kidney, and (3) MSOF is the most common fatal expression of uncontrolled infection.
Insights
Multiple system organ failure (MSOF) is a major cause of death in surgical patients. This study found MSOF is primarily caused by infection, leading to a 74% mortality rate in affected patients.
Area of Science:
- Surgical critical care
- Trauma surgery
- Infectious disease
Background:
- Multiple system organ failure (MSOF) is a significant cause of mortality following major surgery and trauma.
- Understanding the incidence, predisposing factors, and outcomes of MSOF is crucial for improving patient survival.
Purpose of the Study:
- To determine the incidence of MSOF in emergency surgical patients.
- To identify factors predisposing to MSOF.
- To describe the sequelae and mortality associated with MSOF.
Main Methods:
- Prospective study of 553 consecutive emergency surgical patients.
- Collection and analysis of multiple clinical parameters.
- Evaluation of MSOF incidence, contributing factors, and outcomes.
Main Results:
- MSOF occurred in 38 patients, with a mortality rate of 74%.
- Infection was identified as the primary cause of MSOF.
- A common temporal sequence of organ failure was observed: lung, liver, gastric mucosa, and kidney.
Conclusions:
- MSOF is a critical complication predominantly driven by uncontrolled infection.
- The identified sequence of organ failure provides insight into MSOF progression.
- MSOF represents the most frequent fatal outcome of severe, unmanaged infections in surgical settings.