[Scoring multiple organ failure after severe trauma. Comparison of the Goris, Marshall and Moore scores].
BACKGROUND
MOF scores are used to predict, describe and define organ failure. The aim of this study was to compare MOF scoring systems regarding their precision.


METHODS
Data on the ICU course of 301 severely injured patients (PTS > 20, age > 16 years) were documented daily for calculation of three MOF Scores (Goris, Moore, Marshall) for 14 days. Every day the patients were graded by clinical criteria into a group with and a group without MOF by an experienced intensive care physician. The cut-off point for MOF was determined by ROC analysis for each score; the sensitivity and specificity were calculated.


RESULTS
The patients were 36.3 +/- 1.0 years old, the mean injury severity was 36.2 +/- 0.7 points according to the PTS. Forty-seven (15.6%) of all patients died 17.7 +/- 5.6 days after trauma. The MOF incidence was 26.1%, the MOF mortality 58.4%. The calculated cut-off point for MOF was more than 4 points for the Goris and Marshall scores and more than 3 points for the Moore score. The Moore score is, with sensitivity of 81% and specificity of 88%, superior to the other scores. The Moore score identified 93 patients (30.9%) for MOF; this corresponds with a right answer in 85%. The lower specificity of the Goris and Marshall scores was due to the judgement of liver (GOT) and cardiovascular (PAH) dysfunction respectively.


CONCLUSIONS
For evaluation of MOF after severe trauma the Moore score is superior to other scoring systems (sensitivity 81%; specificity 87%). A score of more than 3 points is associated with MOF. The Moore score did not consider distinct parameters (S-GOT, PAH) which are included in the other systems and were of little importance in our calculations.
Grotz
M
M
Unfallchirurgische Klinik, Medizinische Hochschule Hannover. grotz@t-online.de
von Griensven
M
M
Stalp
M
M
Kaufmann
U
U
Hildebrand
F
F
Pape
H C
HC
D000328:Adult; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D009104:Multiple Trauma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D015996:Survival Rate; D015599:Trauma Severity Indices