Evaluation of the organic dysfunction in elderly patients in the intensive care unit

Introduction

The multiple organ dysfunction syndrome (MODS) is the main cause of mortality in intensive care units. The number of patients older than 65 years in such units has progressively been increasing. The aim of this study is to evaluate the frequency and evolution of the MODS in that population and its impact on mortality.

Materials and methods

A prospective, descriptive, longitudinal study. Data has been collected for the calculation of the Sepsis-related Organ Failure Assessment (SOFA) score of the patients in the intensive care unit of a public hospital school between September 2001 and December 2002. The MODS has been defined as a SOFA score ≥ 3 in two or more organs. The other data collected included age, sex, Acute Physiology and Chronic Health Evaluation II score, length of stay and mortality. The statistic analysis has been made by Student t test and the Wilcoxon test as indicated.

Results

A total of 466 patients stayed in the intensive care unit for the period of the study, 176 being older than 65 years. The elderly patients age ranged from 65 to 98 years (75 ± 6 years). The Acute Physiology and Chronic Health Evaluation II and the mortality average rate values were higher if compared with younger patients. The MODS was present in 37% of the patients and its presence increased the risk of death 2.3 times for elderly patients. The dysfunction of the six main organic systems evaluated during the first 5 days presented a relation to mortality.

Conclusion

The presence of MODS occurs in 37% of the elderly population and increases the risk of death 2.3 times. The dysfunction of the main organic systems described by the SOFA score during the first days presented a relation to mortality.