TS18P POST INJURY MULTIPLE ORGAN FAILURE: THE AUSTRALIAN CONTEXT

Abstract

Background The epidemiology of post‐injury multiple organ failure (MOF) is reported to go through changes during the last 15 years. The purpose of this study is to describe the epidemiology of post‐injury MOF in Australia.Methods A 12‐month prospective epidemiological study was performed in a Major Trauma Service. Demographics, injury severity (ISS), physiological, MOF status and outcome data was prospectively collected on all trauma patients who met inclusion criteria (ICU admission; ISS > 15; age > 18, AIS head <3 and survival >48 hrs). MOF was defined by the Denver MOF score. Data are presented as % or Mean+/−SEM. Univariate statistical comparison was performed (Student t‐ and X‐square tests), p < 0.05 was considered significant.Results Twenty‐five patients met inclusion criteria (Age 39+/−5, ISS 27+/−3, Male 60%), three patients (12%) developed MOF. The maximum MOF score was 5.7 +/−1, with duration of 2.3+/−0.7 days. Two patients had respiratory and cardiac failure, while one patient had failure of respiratory, cardiac, hepatic and renal systems. All MOF patients survived. MOF patients tend to have longer ICU stays (18+/−5.5 vs 7+/−0.8 p = 0.17), were older (54+/−17 vs 38+/−5 p = 0.4). None of the previously described independent predictors (ISS, base deficit, lactate, transfusions) were different when the MOF patients were compared with the non‐MOF patients.Conclusion MOF is not as significant a cause of late trauma death as previously reported internationally. Our preliminary data challenges the timeliness of the 10‐year‐old independent predictors of post‐injury MOF. The epidemiology, the clinical presentation and the independent predictors of post‐injury MOF requires reassessment for the Australian context.