| Pneumonia: cause or symptom of postinjury multiple organ failure? | |
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MedLine Citation:
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PMID: 8273837 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Recent studies have shown that selective gut decontamination can reduce the incidence of pneumonia, but this does not decrease multiple organ failure (MOF) or mortality. These findings have prompted the hypothesis that pneumonia is an inconsequential symptom of MOF. To test this, we prospectively evaluated 123 high-risk trauma patients (mean Injury Severity Score = 36.2 +/- 1.5). Organ dysfunction, scored daily according to a 12-point scale, ultimately developed in 28 (23%) patients. Major infections were diagnosed, based on strict criteria, in 59 patients (48%), and pneumonia developed in 52 patients (43%). Pneumonia was significantly associated with MOF (82% of patients with MOF versus 30% of patients without MOF, p < 0.0001). In 14 (50%) of the patients with MOF, pneumonia preceded a significant rise (greater than or equal to 3) in serial MOF scoring. Of note, 10 (71%) of these patients died. Among the remaining 14 patients with MOF, 10 developed pneumonia, but this was associated with a minimal increase (less than or equal to 2) in MOF scoring (3 patients died). These data, by temporal association with MOF scoring, implicate pneumonia in precipitating or significantly worsening organ failure in 50% of the patients who developed MOF. |
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Authors:
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A Sauaia; F A Moore; E E Moore; J B Haenel; R A Read |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: American journal of surgery Volume: 166 ISSN: 0002-9610 ISO Abbreviation: Am. J. Surg. Publication Date: 1993 Dec |
Date Detail:
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Created Date: 1994-02-01 Completed Date: 1994-02-01 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0370473 Medline TA: Am J Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 606-10; discussion 610-1 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgical, Denver General Hospital, Colarado 80204-4507. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Female Humans Male Middle Aged Multiple Organ Failure / complications, etiology* Pneumonia / complications, etiology*, mortality Prospective Studies Time Factors Wounds and Injuries / complications*, mortality |
| Grant Support | |
ID/Acronym/Agency:
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P50-GM49222/GM/NIGMS NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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