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Related Experiment Videos

Severity stratification and outcome prediction for multisystem organ failure and dysfunction

J E Zimmerman1, W A Knaus, X Sun

  • 1ICU Research Unit, Department of Anesthesiology, George Washington University Medical Center, 2300 K Street N.W., Washington, D.C. 20037, U.S.A.

World Journal of Surgery
|May 1, 1996
PubMed
Summary

Multiple organ system failure (MOSF) is a significant cause of death in hospitalized adults. While mortality for single or double organ failure remained high in the 1980s, survival improved for those with three or more failures.

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Area of Science:

  • Critical Care Medicine
  • Prognostic Research
  • Clinical Outcomes

Background:

  • Multiple organ system failure or dysfunction (MOSF/MODS) is a leading cause of death in hospitalized patients.
  • Risk factors for MOSF/MODS include physiological derangement, injury type, age, and comorbidities.
  • Hospital mortality for single organ system failure (OSF) approached 40%, and for two OSFs, it reached 60% during the 1980s.

Purpose of the Study:

  • To analyze trends in mortality for patients with MOSF/MODS during the 1980s.
  • To evaluate the effectiveness of risk factor assessment for predicting outcomes in MOSF/MODS.
  • To demonstrate the utility of dynamic risk assessment for improving patient care and research.

Main Methods:

  • Retrospective analysis of patient data from the 1980s.

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  • Categorization of patients based on the number and duration of organ system failures.
  • Development and application of a comprehensive risk factor assessment model for outcome prediction.

    • Main Results:

    • Mortality for single OSF exceeded 40%, and for two OSFs, it reached 60%, with no significant change over the decade.
    • Mortality for patients with three or more OSFs decreased from 98% to 84% between 1982 and 1990 (p = 0.0003).
    • Comprehensive risk factor assessment proved more effective for outcome prediction than simply counting OSFs.

    Conclusions:

    • While mortality for multiple organ system failure remains high, there has been a significant improvement in survival for patients with three or more organ failures.
    • Accurate, dynamic risk prediction using comprehensive patient assessments is crucial for improving patient management and therapeutic research in critical care.
    • Daily reassessment of risk factors enhances prediction accuracy, reflecting patient response to therapy and complications.