Clinical Profile and Outcome of Multiple Organ Dysfunction Syndrome (MODS) in a Tertiary Care Centre of Manipal, Karnataka

2021 ◽  
Vol 8 (41) ◽  
pp. 3547-3552
Author(s):  
Manthappa Marijayanth ◽  
Ashok Horatti ◽  
Varsha Tandure ◽  
Suheil Dhanse
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Sofa Score ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Multiple Organ ◽  
Adult Patients ◽  
Clinical Profile ◽  
Care Hospital ◽  
Multiple Organ Dysfunction

BACKGROUND To study the clinical profile and outcome of multiple organ dysfunction syndrome (MODS) in previously healthy adult patients and to assess the correlation between sequential organ failure assessment (SOFA) score at admission and mortality in these patients. METHODS This study was conducted at a tertiary care hospital attached to a medical college of south India. This was a prospective observational study. All adult patients presenting with multiple organ dysfunction syndrome between October 2010 and June 2012 were selected for the study. SOFA score was recorded for all the patients at the time of admission. Patients were followed up till the time of death or discharge. RESULTS In this study, majority of the cases were males and belonged to middle age group. Epidemic diseases such as scrub typhus and leptospirosis were the most common causes of MODS. Fever was the most common presenting symptom of MODS. Majority of patients recovered. Higher SOFA score at admission is associated with increased mortality, duration of hospital stay, requirement of ventilatory support, haemodialysis, and central venous access. CONCLUSIONS Infectious diseases are responsible for most cases of MODS. Higher SOFA score at admission is associated with increased morbidity and mortality. Majority of people recover with appropriate treatment. KEYWORDS MODS, Clinical Profile, SOFA Score, Outcome

IMPACT probability of poor outcome and plasma cytokine concentrations are associated with multiple organ dysfunction syndrome following traumatic brain injury

2019 ◽  
Vol 131 (6) ◽  
pp. 1931-1937 ◽  
Author(s):  
Sungho Lee ◽  
Hyunsoo Hwang ◽  
Jose-Miguel Yamal ◽  
J. Clay Goodman ◽  
Imoigele P. Aisiku ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Sofa Score ◽  
Plasma Concentrations ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Poor Outcome ◽  
Initial Plasma

OBJECTIVETraumatic brain injury (TBI) is a major cause of morbidity and mortality. Multiple organ dysfunction syndrome (MODS) occurs frequently after TBI and independently worsens outcome. The present study aimed to identify potential admission characteristics associated with post-TBI MODS.METHODSThe authors performed a secondary analysis of a recent randomized clinical trial studying the effects of erythropoietin and blood transfusion threshold on neurological recovery after TBI. Admission clinical, demographic, laboratory, and imaging parameters were used in a multivariable Cox regression analysis to identify independent risk factors for MODS following TBI, defined as maximum total Sequential Organ Failure Assessment (SOFA) score > 7 within 10 days of TBI.RESULTSTwo hundred patients were initially recruited and 166 were included in the final analysis. Respiratory dysfunction was the most common nonneurological organ system dysfunction, occurring in 62% of the patients. International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) probability of poor outcome at admission was significantly associated with MODS following TBI (odds ratio [OR] 8.88, 95% confidence interval [CI] 1.94–42.68, p < 0.05). However, more commonly used measures of TBI severity, such as the Glasgow Coma Scale, Injury Severity Scale, and Marshall classification, were not associated with post-TBI MODS. In addition, initial plasma concentrations of interleukin (IL)–6, IL-8, and IL-10 were significantly associated with the development of MODS (OR 1.47, 95% CI 1.20–1.80, p < 0.001 for IL-6; OR 1.26, 95% CI 1.01–1.58, p = 0.042 for IL-8; OR 1.77, 95% CI 1.24–2.53, p = 0.002 for IL-10) as well as individual organ dysfunction (SOFA component score ≥ 1). Finally, MODS following TBI was significantly associated with mortality (OR 5.95, 95% CI 2.18–19.14, p = 0.001), and SOFA score was significantly associated with poor outcome at 6 months (Glasgow Outcome Scale score < 4) when analyzed as a continuous variable (OR 1.21, 95% CI 1.06–1.40, p = 0.006).CONCLUSIONSAdmission IMPACT probability of poor outcome and initial plasma concentrations of IL-6, IL-8, and IL-10 were associated with MODS following TBI.

Impaired chemoreflex sensitivity in adult patients with multiple organ dysfunction syndrome?the potential role of disease severity

2004 ◽  
Vol 30 (4) ◽  
pp. 665-672 ◽  
Author(s):  
Hendrik Schmidt ◽  
Ursula M�ller-Werdan ◽  
Sebastian Nuding ◽  
Thomas Hoffmann ◽  
Darrel P. Francis ◽  
...  
Keyword(s):  
Disease Severity ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Potential Role ◽  
Multiple Organ ◽  
Adult Patients ◽  
Multiple Organ Dysfunction ◽  
Chemoreflex Sensitivity

scholarly journals Multiple Organ Dysfunction Syndrome- Clinical Profile, Associations and Outcome in Critically ill Children Aged 1 Month to 14 Years Admitted to PICU in Nobel Medical College Teaching Hospital in Biratnagar

2019 ◽  
Vol 4 (1) ◽  
pp. 629-633
Author(s):  
Arun Giri ◽  
Sunil Kumar Yadav ◽  
Vijay Sah ◽  
Niraj Niroula ◽  
Binayak Singh
Keyword(s):  
Developing Countries ◽  
Organ Dysfunction ◽  
Teaching Hospital ◽  
Multiple Organ Dysfunction Syndrome ◽  
College Teaching ◽  
Multiple Organ ◽  
Clinical Profile ◽  
Critically Ill Children ◽  
Multiple Organ Dysfunction ◽  
Medical College

Introduction: Multiple organ dysfunction syndrome (MODS), characterized by a progressive physiologic dysfunction involving two or more organ systems after an acute threat to systemic homeostasis, is not a rare entity among patients admitted to the pediatric intensive care units. Despite recent advances made in the medical technology and newer treatment strategies, large numbers of deaths in the PICU are attributable to MODS. Objective: To describe the clinical profile of MODS among children admitted in PICU and to observe its associations and outcome. Methodology: A hospital based prospective observational study was conducted in PICU of Nobel medical college teaching hospital, Biratnagar, Nepal from June 2017- May 2018. Children aged 1 month to 14 years admitted in the PICU with various medical and surgical illnesses were included in the study. All variables defining MODS and the data showing the presence or absence of sepsis were collected within 1 hour of admission (day 0) and then every day until transfer or discharge from PICU or until patient's death. Results: Out of 150 admissions in the PICU, 103 fulfilled the inclusion criteria, and were enrolled in the study. A total of 53 patients (51%) developed MODS at some time during their stay at PICU and 88.7% of them had it at the time of admission. Of 103 cases under study, 26 died (mortality rate = 25.2%) and 92.3% of deaths were attributable to MODS. Children with neurological involvement had the highest risk of death [odds ratio (OR), 19.8; 95% confidence interval (95%CI), 4.37-90.30]. 75.5% of children with MODS had some sort of infection and 49% of them had sepsis. Conditions like SIRS, Sepsis, Severe sepsis, Septic shock and ARDS in the study patients were found significantly associated with MODS. Conclusion: A MODS is a common clinical entity among patients admitted to the PICU and are associated with significant mortality and morbidity. In children, MODS usually seem to develop early and in a simultaneous way. In developing countries like ours, morbidity and mortality associated with MODS in the PICUs is higher than that in the developed countries. Prevalence of sepsis in children with or without MODS is greater in the developing countries. Sepsis is further responsible for larger number of deaths in PICU.

scholarly journals Comparison of Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation II and IV (APACHE) Scoring System Validity as Mortality Predictors in ICU Patients with Multiple Organ Dysfunction Syndrome in Sepsis

2021 ◽  
Vol 8 (16) ◽  
pp. 1058-1063
Author(s):  
Akshay Hiryur Manjunatha Swamy ◽  
Girish Bandigowdanahalli Kumararadhya ◽  
Srinivas Hebbal Thammaiah ◽  
Nanda Karikere Siddagangaiah ◽  
Shiva Kumar K.G
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Sofa Score ◽  
Multiple Organ ◽  
Apache Ii ◽  
Multiple Organ Dysfunction ◽  
Icu Patients ◽  
Significant Difference ◽  
The Mean ◽  
Apache Iv

BACKGROUND Multiple organ dysfunction syndrome (MODS) has recently been considered as a defining syndrome of sepsis and is responsible for a high mortality rate among the patients in the intensive care units (ICUs). Prognostication of the ICU patients is an integral part of the management of the critically ill patients and many scoring systems, for that matter, have been devised and compared for their efficiency at predicting mortality. This study was conducted to evaluate and compare the validity of sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE II) and APACHE IV as mortality predictors in intensive care unit (ICU) patients suffering from MODS in sepsis. METHODS Hundred patients diagnosed with MODS in sepsis were carefully examined, followed by relevant laboratory investigations. The SOFA score was calculated daily, and the APACHE II and IV scores were calculated on the day of admission. The scores were further compared among the survivors and the non-survivors, followed by receiver operating characteristic (ROC) curve analysis of the SOFA D1, D2, and D3 and the APACHE II and IV scores to estimate their capability of mortality prediction. RESULTS The means of the APACHE II, IV and SOFA D1 were 16.57 ± 6.49, 71.91 ± 16.19 and 8.75 ± 2.20, respectively. There was a statistically significant difference in the mean APACHE II scores (14.23 ± 5.20 vs. 21.12 ± 6.38) and the mean APACHE IV scores (67.27 ± 13.21 vs. 80.91 ± 17.77) in the survivors and the nonsurvivors. A statistically significant difference was also evident in the mean ages of the survivors and the non-survivors (52.82 ± 14.67 years vs. 63.25 ± 16.98 years). The SOFA score was high among the non-survivors than the survivors right from day-1 (10.24 ± 2.08 vs. 7.98 ± 1.86) to day-20 (15.00 ± 0.00 vs. 3.14 ± 0.38). Furthermore, ROC analysis showed that the best discrimination was provided by SOFA D3 followed by the APACHE II and SOFA D1 scores, with APACHE IV score showing the least. CONCLUSIONS SOFA score on day 3 provides the best mortality prediction in patients with MODS in sepsis, as compared to APACHE II and IV scores. KEYWORDS SOFA, APACHE II, APACHE IV, Multiple Organ Dysfunction Syndrome, Sepsis

Multiple Organ Dysfunction Syndrome of Alcoholic Origin in an 18-Year-Old Patient

2018 ◽  
Vol 2 (12) ◽  
Author(s):  
Francesco Gazia ◽  
Giacomo De Luca ◽  
Imbalzano Gabriele ◽  
Vincenzo Pellicanò
Keyword(s):  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction
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