Postinjury multiple organ failure : A bimodal phenomenon. Discussion.
Annual Meeting of the American Association for the Surgery of Trauma. Halifax, Nova Scotia CAN, 1995/09/27.
To better define the epidemiology of postinjury multiple organ failure (MOF), we prospectively evaluated 457 high-risk trauma patients who survived more than 48 hours.
Overall, 70 (15%) developed MOF.
In 27 (39%) patients, the occurrence was early, while in 43 (61%) patients the presentation was delayed.
At presentation, early MOF had more cardiac dysfunction, while late MOF had greater hepatic failure.
Indices of shock were more critical risk factors for early MOF, while advanced age was more important for late MOF.
While early and late MOF had a similar high incidence of major infections, these appeared to be more important in precipitating late MOF.
Finally, while mortality is similar, early MOF patients appear to succumb faster.
In conclusion, postinjury MOF remains a significant challenge and appears to present in at least two patterns (i.e., early versus late).
Better understanding of the relative roles of the dysfunctional inflammation and infections in early MOF versus late MOF may facilitate the development of new strategies for the prevention and treatment of morbid syndrome.
Mots-clés Pascal : Polytraumatisme, Complication, Insuffisance organique multiple, Symptomatologie, Caractérisation, Prévalence, Evolution, Epidémiologie, Homme, Traumatisme, Réanimation
Mots-clés Pascal anglais : Multiple injury, Complication, Multiple organ failure, Symptomatology, Characterization, Prevalence, Evolution, Epidemiology, Human, Trauma, Resuscitation
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Cote : 96-0229572
Code Inist : 002B16K. Création : 199608.