Influence of multiple organ dysfunction syndrome on duration of critical illness and hospitalization

Archives of Surgery
P S Barie, L J Hydo

Abstract

Multiple organ dysfunction syndrome (MODS) is the leading cause of death in the general surgery intensive care unit (SICU). The development of MODS is a powerful predictor of prolonged SICU stay in survivors and nonsurvivors of critical illness, but its relation to less severe illness and briefer duration of care is unknown. To determine the relation between modest degrees of MODS and length of stay in the SICU and hospital and whether daily MOD score calculations can distinguish survivors from nonsurvivors before the SICU stay becomes prolonged. An SICU of a university tertiary care medical center. Prospective inception-cohort study. Illness severity data were collected in retrospect only for the calendar year 1991. Of 2646 consecutive patients studied, 115 stayed in the SICU more than 21 days. Acute Physiology and Chronic Health Evaluation (APACHE) II and III scores were calculated after 24 hours, with daily and cumulative MOD scores (0-4 points for 6 organs, 24 points maximum). Patients were followed up until hospital discharge or death. Data analysis was performed by unpaired 2-tailed t test, exact contingency analysis for multiple groups, univariate 1- or 2-way analysis of variance with repeated measures, or linear or poly...Continue Reading

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