Role of systemic inflammatory response syndrome and infection in the occurrence of early multiple organ dysfunction syndrome following severe trauma.

OBJECTIVE

To evaluate the role of infection and systemic inflammatory response syndrome (SIRS) on the occurrence of early posttraumatic MODS.

DESIGN

Retrospective study.

SETTING

University Teaching Hospital ICU.

PATIENTS

163 consecutive patients hospitalized for more than 48 hours following severe trauma.

MEASUREMENTS AND MAIN RESULTS

The patients were classified into two groups in respect to the existence of MODS at day 2. There was 27 patients in the MODS group and 136 patients in the no MODS group. The two groups were similar with respect to age, sex ratio and Simplified Acute Physiology Score. The MODS group had a higher mortality (52 versus 7%), Injury Severity Score (45 +/- 14 versus 31 +/- 13), hypovolemic shock rate (74 versus 30%), massive volume replacement rate (59 versus 6%) and SIRS rate (81 versus 54%) than the no MODS group (P < 0.05). The rate of infection was similarly low in the MODS and no MODS group (4 versus 6% respectively).

CONCLUSION

Early MODS is often associated with hypotension and massive volume administration but very rarely with infection, despite the high rate of SIRS.