Cited by 491Trauma and Emergency Care StudiesTrauma, Hemostasis, Coagulopathy, ResuscitationSepsis Diagnosis and Treatment

Postinjury Multiple Organ Failure: A Bimodal Phenomenon

Moore, Frederick A., Sauaia, Angela, Moore, Ernest E., Haenel, James B., Burch, Jon M., Lezotte, Dennis C.·1996·The Journal of Trauma: Injury, Infection, and Critical Care

Abstract

To better define the epidemiology of postinjury multiple organ failure (MOF), we prospectively evaluated 457 high-risk trauma patients who survived more than 48 hours. Overall, 70 (15%) developed MOF. In 27 (39%) patients, the occurrence was early, while in 43 (61%) patients the presentation was delayed. At presentation, early MOF had more cardiac dysfunction, while late MOF had greater hepatic failure. Indices of shock were more critical risk factors for early MOF, while advanced age was more important for late MOF. While early and late MOF had a similar high incidence of major infections, these appeared to be more important in precipitating late MOF. Finally, while mortality is similar, early MOF patients appear to succumb faster. In conclusion, postinjury MOF remains a significant challenge and appears to present in at least two patterns (i.e., early versus late). Better understanding of the relative roles of the dysfunctional inflammation and infections in early MOF versus late MOF may facilitate the development of new strategies for the prevention and treatment of morbid syndrome.

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Crossref · 10.1097/00005373-199604000-00001

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  • Patients in intensive care suffering from shock, infection, or trauma react inadequately to a renewed challenge like surgery, the second hit phenomenon.

    “It has long been known that patients in intensive care suffering from shock, infection, or trauma react inadequately to a renewed challenge like surgery. This has also been called the phenomenon of the second hit.126, 127, 128, 129, 130, 131”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [126]

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Authors
Moore, F. A., Sauaia, A., Moore, E. E., Haenel, J. B., Burch, J. M., & Lezotte, D. C.
Affiliations
Denver Health Medical Center (US)
Venue
The Journal of Trauma: Injury, Infection, and Critical Care
Published
1996-04
Volume
40
Issue
4
Pages
501-512
ISSN
1079-6061
OpenAlex
W2002764610
Cited by
491
References
51
Citations by year
2026: 4 · 2025: 2 · 2024: 10 · 2023: 7 · 2022: 11 · 2021: 11 · 2020: 14 · 2019: 10 · 2018: 19 · 2017: 12 · 2016: 15 · 2015: 30 · 2014: 22 · 2013: 28 · 2012: 21
FWCI
23.00
Type
journal article
Language
en
Open access
closed
Locations
PubMed (publishedVersion)
Funders
National Institute of General Medical Sciences (P50-GM-49222-0, P50GM049222)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
multiple organ failure, trauma patients, liver failure, cardiac dysfunction, shock, infection, risk factors, mortality, sepsis, systemic inflammation
MeSH terms
Adolescent, Adult, Female, Humans, Male, Middle Aged, Multiple Organ Failure, Prospective Studies, Risk Factors, Time Factors, Wounds and Injuries, Injury Severity Score

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