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Postinjury Multiple Organ Failure: A Bimodal Phenomenon
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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“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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Metadata
- 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 › Critical Care and Intensive Care Medicine › 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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