CHICAGO Improvements in critical care and decreased use of blood transfusions over the course of the last decade are associated with decreases in the rate, severity and risk of death from post-injury multiple organ failure, according to a study in the May issue of Archives of Surgery, one of the JAMA/Archives journals.

Multiple organ failure (MOF) following injury is a leading cause of in-hospital death and is currently believed to be the result of uncontrolled, systemic inflammation, according to background information in the article. Age of the patient, severity of the injury and receiving a blood transfusion within 12 hours of injury have previously been identified as risk factors. Recent studies have suggested that the incidence and death rate from multiple organ failure has been decreasing due to advances in trauma and critical care.

David J. Ciesla, M.D., of the Denver Health Medical Center, and colleagues analyzed data on severely injured patients admitted to the Rocky Mountain Regional Trauma Center over the course of a 12-year period ending December 31, 2003, to determine whether the incidence and severity of multiple organ failure had decreased over the course of the last decade and to determine whether risk factors for multiple organ failure had changed over the course of the study. Multiple organ failure is based on evaluation of four organ systems, pulmonary, liver, kidney and cardiac. Single organ failure is defined by a dysfunction grade of one or greater on a scale of zero (best) to three (worse). Post-injury multiple organ failure is defined by a total score for the four organ systems of four or more within 48 hours after injury.

Of the 1,244 severely injured patients admitted over the 12-year period, 112 patients (eight percent) died. Of the 339 (25 percent) who developed multiple organ failure, 90 (27 percent) died. Over the course of the study there was a significant increase in the age of patients admitted and the sev
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Contact: Donna Kettenbach
303-436-6606
JAMA and Archives Journals
16-May-2005

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