Document Detail


Pneumonia: cause or symptom of postinjury multiple organ failure?
MedLine Citation:
PMID:  8273837     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A Sauaia; F A Moore; E E Moore; J B Haenel; R A Read
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of surgery     Volume:  166     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1994-02-01     Completed Date:  1994-02-01     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  606-10; discussion 610-1     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgical, Denver General Hospital, Colarado 80204-4507.
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MeSH Terms
Descriptor/Qualifier:
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:
P50-GM49222/GM/NIGMS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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