Role of systemic inflammatory response syndrome and infection in the occurrence of early multiple organ dysfunction syndrome following severe trauma.
OBJECTIVE
To evaluate the role of infection and systemic inflammatory response syndrome (SIRS) on the occurrence of early posttraumatic MODS.


METHODS
Retrospective study.


METHODS
University Teaching Hospital ICU.


METHODS
163 consecutive patients hospitalized for more than 48 hours following severe trauma.


RESULTS
The patients were classified into two groups in respect to the existence of MODS at day 2. There was 27 patients in the MODS group and 136 patients in the no MODS group. The two groups were similar with respect to age, sex ratio and Simplified Acute Physiology Score. The MODS group had a higher mortality (52 versus 7%), Injury Severity Score (45 +/- 14 versus 31 +/- 13), hypovolemic shock rate (74 versus 30%), massive volume replacement rate (59 versus 6%) and SIRS rate (81 versus 54%) than the no MODS group (P < 0.05). The rate of infection was similarly low in the MODS and no MODS group (4 versus 6% respectively).


CONCLUSIONS
Early MODS is often associated with hypotension and massive volume administration but very rarely with infection, despite the high rate of SIRS.
Smail
N
N
Département d'Anesthésie-Réanimation, Université Paris-Sud, Hôpital de Bicêtre, Le Kremlin, France.
Messiah
A
A
Edouard
A
A
Descorps-Declère
A
A
Duranteau
J
J
Vigué
B
B
Mimoz
O
O
Samii
K
K
D000328:Adult; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D007239:Infections / Q000150:complications*; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000145:classification / Q000209:etiology*; D009104:Multiple Trauma / Q000150:complications*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012769:Shock / Q000150:complications; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications*