title: [Assessment of prognostic and influencing factors in elderly patients with multiple organ dysfunction syndrome].
abstract: OBJECTIVE
  To preliminarily assess the prognosis of patients with multiple organ dysfunction syndrome (MODSE) and analyze their influencing factors.
  
  
  METHODS
  The clinical data of 365 MODSE patients admitted into Chinese PLA General Hospital during January 2009 to June 2012 were analyzed retrospectively. According to 28-day outcomes, they were divided into 2 groups (28-day survival and non-survival) while 4 groups according to age. Then these prognosis were evaluated with the current scoring systems ((acute physiology and chronic health evaluation II (APACHEII and III), sample acute physiological score (SAPSII) and multiple organ dysfunction score (MODS)). The predictive powers were compared by receiver operating characteristic (ROC) curve. Finally a binary Logistic regression analysis was performed to evaluate the relevant influencing prognostic factors of MODSE.
  
  
  RESULTS
  The mean age was (77.8 ± 9.1) years, mean number of failed organs (3.6 ± 1.2) and a 28-day mortality 45.8%. The ages of non-survival group were older than those of survival group ((78.1 ± 9.1) vs (76.7 ± 11.0) years). The number of organ failures ((4.3 ± 1.1) vs (3.1 ± 1.0)) and scores (APACHEII: (28 ± 7) vs (20 ± 8), APACHE III: (106 ± 27) vs (75 ± 31), SAPSII: (64 ± 16) vs (46 ± 18), MODS: (9 ± 3) vs (6 ± 3)) of non-survivals were significantly higher than that of survivals. The area under ROC curve of these four score systems were 0.790, 0.781, 0.780 and 0.780 respectively. Compared to the above systems, SAPSII had the best performance in sensitivity while APACHEII was more valuable in specificity. All clinical data underwent binary Logistic regression and the results showed that plasma concentration of albumin and mean arterial pressure (MAP) offered beneficial outcomes while age and number of organ failures had unfavorable prognosis. The greater patient age, the higher their mortality.
  
  
  CONCLUSIONS
  All four scoring systems have accurate prognostic predictions of MODSE patients. And the predictive power of APACHEII is the best. Plasma concentration of albumin, MAP, age and organ failure number are independent prognostic factors in MODSE patients.
authors.affiliation: Department of Respiratory Disease, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Xiao
authors.forename: Chao
authors.initials: C
authors.lastname: Guo
authors.forename: Long-xiang
authors.initials: LX
authors.lastname: Su
authors.forename: Lin
authors.initials: L
authors.lastname: Feng
authors.forename: Zhao-xu
authors.initials: ZX
authors.lastname: Jiang
authors.forename: Ke
authors.initials: K
authors.lastname: Chen
authors.forename: Dan
authors.initials: D
authors.lastname: Feng
authors.forename: Yan-hong
authors.initials: YH
authors.lastname: Jia
authors.forename: Dan-yang
authors.initials: DY
authors.lastname: She
authors.forename: Li-xin
authors.initials: LX
authors.lastname: Xie
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index