Multiple organ dysfuntion in ARDS

Introduction

The multiple organ dysfunction syndrome (MODS) is a major cause of mortality in ARDS. However, there are few studies evaluating this relationship using new score systems for MODS.

Methods

All patients in the ICU who met American-European Consensus criteria for ARDS [1] between November 1998 and December 2000 were included in the analysis. Criteria for MODS were those proposed by Marshall et al [2]. Age, gender, APACHEII score and outcome were also evaluated. The patients were divided into survivors (SV) and nonsurvivors (NSV). The differences between groups were analyzed with t-test, ?² and Mann-Whitney as indicated.

Results

There were 975 admissions to the ICU, of whom 64 (6.6%) presented ARDS criteria. The mean age was 35 ± 13 years and 54 ± 16 years (P < 0.001), and the APACHEII was 16.4 ± 3.3 and 20 ± 5.2 (P = 0.02) in SV and NSV, respectively. General mortality was 79% (n = 51), 39% (n = 20) in females and 61% (n = 31) in males (P = 0.066). The results of the MODS in SV and NSV are shown in the Table.

Table

Conclusion

The severity of MODS measured by a specific score is associated with increased mortality in ARDS. Advanced age, male gender and individual dysfunction of renal and hepatic systems were associated with a poor prognosis.