Tran D D, Groeneveld A B, van der Meulen J, Nauta J J, Strack van Schijndel R J, Thijs L G
Department of Internal Medicine, Free University Hospital, Amsterdam, The Netherlands.
Crit Care Med. 1990 May;18(5):474-9. doi: 10.1097/00003246-199005000-00002.
We retrospectively studied relations between age, pre-existing chronic disease, sepsis, organ system failure, and mortality in 487 patients from a medical ICU. Single organ system failure (SOSF) occurred in 136 (28%) and multiple (greater than or equal to 2) organ system failure (MOSF) in 187 (38%) patients. Cardiovascular and pulmonary failure predominated. Overall mortality was 27%. SOSF mortality was 16% and for MOSF 58%. Eighty-three percent of nonsurvivors had MOSF. Hence, MOSF is common and a major cause of death in critically ill medical patients. Advancing age and prior chronic disease may diminish physiologic reserve and predispose to sepsis and MOSF. Although sepsis is a major risk factor for MOSF, a nonspecific host response to critical illness may contribute to the syndrome in 35% of patients. Advancing age, chronic disease, and the number of failing organs, particularly failure of cardiovascular, pulmonary, renal, and neurologic systems, are major determinants of overall mortality, but sepsis is not an independent contributor.
我们对一家内科重症监护病房的487例患者进行了回顾性研究，以探讨年龄、既往慢性病、脓毒症、器官系统衰竭与死亡率之间的关系。136例（28%）患者发生单器官系统衰竭（SOSF），187例（38%）患者发生多器官系统衰竭（MOSF，即两个或以上器官系统衰竭）。以心血管和肺衰竭最为常见。总体死亡率为27%。SOSF死亡率为16%，MOSF死亡率为58%。83%的死亡患者患有MOSF。因此，MOSF在重症内科患者中很常见，是主要死因。年龄增长和既往慢性病可能会降低生理储备，易发生脓毒症和MOSF。虽然脓毒症是MOSF的主要危险因素，但在35%的患者中，对危重病的非特异性宿主反应可能也导致了该综合征。年龄增长、慢性病以及衰竭器官的数量，特别是心血管、肺、肾和神经系统的衰竭，是总体死亡率的主要决定因素，但脓毒症并非独立的决定因素。
