LONG-TERM TRENDS IN MULTIPLE ORGAN DYSFUNCTION SYNDROME AFTER SEVERE POLYTRAUMA: AN 11-YEAR PROSPECTIVE ANALYSIS kwessem@umcutrecht.nl

 

LONG-TERM TRENDS IN MULTIPLE ORGAN DYSFUNCTION SYNDROME AFTER SEVERE POLYTRAUMA: AN 11-YEAR PROSPECTIVE ANALYSIS

3

Netherlands

Oral or Poster

Advances in trauma care have reduced Multiple Organ Dysfunction Syndrome (MODS) incidence, yet it remains a leading cause of morbidity and mortality. We evaluated trends in MODS incidence, mortality, and organ failure patterns in polytrauma patients over the last decade.

Since 2014, a prospective study was conducted including consecutive trauma patients admitted to a Level-1 Trauma Center ICU. Patients with drowning, asphyxiation, burns, or death <48h were excluded. Demographics, Injury Severity Score(ISS), physiological and resuscitation parameters, and Denver Multiple Organ Failure(MOF) scores were recorded prospectively. Data are presented as median(IQR), with p<0.05 considered significant.

A total of 802 patients were included (median age 47 [29–62] years; 72% male; ISS 29 [22–36]); 95% sustained blunt injuries. MODS developed in 15% of patients, with only 4 deaths(3%) attributable to MODS Median highest Denver MOF score was 4(4-5). Median time to MODS onset was 3(3-5) days after injury with a length of 2(1-4) days. Age, ISS, Crystalloids<24h, and FFP<24h were independent predictors for MODS. During the studied period there was no change in incidence in MODS development, nor in MODS related death, nor was there any difference in time to MODS onset, and days of (consecutive)MODS. There was a slight decrease in highest Denver MOF score over time (p=0.04). Over time, the severity of pulmonary and cardiac organ failure increased whereas hepatic failure decreased, and renal failure remained stable.

In severely injured polytrauma patients, MODS presentation remained remarkably stable over 11 years, generally mild, and predominantly involving cardiac and pulmonary dysfunction.