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Erschienen in: Intensive Care Medicine 12/2003

01.12.2003 | Original

Validation of the multiple organ dysfunction (MOD) score in critically ill medical and surgical patients

verfasst von: Thomas A. Buckley, Charles D. Gomersall, Sarah J. Ramsay

Erschienen in: Intensive Care Medicine | Ausgabe 12/2003

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Abstract

Objective

To validate the Multiple Organ Dysfunction (MOD) score externally.

Design

Prospective observational cohort study.

Setting

Mixed medical/surgical ICU in a tertiary referral university hospital.

Patients and participants

Thousand eight hundred and nine patients admitted to ICU for more than 24 h over a 3-year period.

Interventions

None.

Measurements and results

The MOD score was calculated daily for all patients. The criterion validity of the individual organ scores, the maximal MOD score and the change in MOD score were assessed by examining the relationship between increasing scores and ICU mortality. Increased maximal MOD scores and each of the six individual organ scores, and change in MOD scores were associated with increased mortality.

Conclusions

Maximal and individual organ scores have criterion validity when tested in a different ICU from that in which the scores were derived, indicating that the scoring systems are reproducible. The association of change in MOD score with mortality indicates that the score is responsive. These data, combined with previous data establishing concept and content validity, indicate that the MOD score is a valid measure of multi-organ dysfunction.
Literatur
1.
Zurück zum Zitat Petros AJ, Marshall JC, van Saene HK (1995) Should morbidity replace mortality as an endpoint for clinical trials in intensive care? Lancet 345:369–371CrossRef Petros AJ, Marshall JC, van Saene HK (1995) Should morbidity replace mortality as an endpoint for clinical trials in intensive care? Lancet 345:369–371CrossRef
2.
Zurück zum Zitat Deitch EA (1992) Multiple organ failure. Pathophysiology and potential future therapy. Ann Surg 216:117–134CrossRef Deitch EA (1992) Multiple organ failure. Pathophysiology and potential future therapy. Ann Surg 216:117–134CrossRef
3.
Zurück zum Zitat De Mendonca A, Vincent JL, Suter PM, Moreno R, Dearden NM, Antonelli M, Takala J, Sprung C, Cantraine F (2000) Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score. Intensive Care Med 26:915–921CrossRef De Mendonca A, Vincent JL, Suter PM, Moreno R, Dearden NM, Antonelli M, Takala J, Sprung C, Cantraine F (2000) Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score. Intensive Care Med 26:915–921CrossRef
4.
Zurück zum Zitat Angus DC, Musthafa AA, Clermont G, Griffin MF, Linde-Zwirble WT, Dremsizov TT, Pinsky MR (2001) Quality-adjusted survival in the first year after the acute respiratory distress syndrome. Am J Respir Crit Care Med 163:1389–1394CrossRef Angus DC, Musthafa AA, Clermont G, Griffin MF, Linde-Zwirble WT, Dremsizov TT, Pinsky MR (2001) Quality-adjusted survival in the first year after the acute respiratory distress syndrome. Am J Respir Crit Care Med 163:1389–1394CrossRef
5.
Zurück zum Zitat Vincent JL, Moreno R, Takala J, Willatts S, de Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis- Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 22:707–710CrossRef Vincent JL, Moreno R, Takala J, Willatts S, de Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis- Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 22:707–710CrossRef
6.
Zurück zum Zitat Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ (1995) Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med 23:1638–1652CrossRef Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ (1995) Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med 23:1638–1652CrossRef
7.
Zurück zum Zitat Moreno R, Vincent JL, Matos R, Mendonca A, Cantraine F, Thijs L, Takala J, Sprung C, Antonelli M, Bruining H, Willatts S (1999) The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Working Group on Sepsis-related Problems of the ESICM. Intensive Care Med 25:686–696CrossRef Moreno R, Vincent JL, Matos R, Mendonca A, Cantraine F, Thijs L, Takala J, Sprung C, Antonelli M, Bruining H, Willatts S (1999) The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Working Group on Sepsis-related Problems of the ESICM. Intensive Care Med 25:686–696CrossRef
8.
Zurück zum Zitat Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine. Crit Care Med 26:1793–1800CrossRef Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine. Crit Care Med 26:1793–1800CrossRef
9.
Zurück zum Zitat Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL (2001) Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA 286:1754–1758CrossRef Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL (2001) Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA 286:1754–1758CrossRef
10.
Zurück zum Zitat McKay CJ, Curran F, Sharples C, Baxter JN, Imrie CW (1997) Prospective placebo-controlled randomized trial of lexipafant in predicted severe acute pancreatitis. Br J Surg 84:1239–1243PubMed McKay CJ, Curran F, Sharples C, Baxter JN, Imrie CW (1997) Prospective placebo-controlled randomized trial of lexipafant in predicted severe acute pancreatitis. Br J Surg 84:1239–1243PubMed
11.
Zurück zum Zitat Reinhart K, Menges T, Gardlund B, Zwaveling JH, Smithes M, Vincent JL, Tellado JM, Salgado-Remigio A, Zimlichman R, Withington S, Tschaikowsky K, Brase R, Damas P, Kupper H, Kempeni J, Eiselstein J, Kaul M (2001) Randomized, placebo-controlled trial of the anti-tumor necrosis factor antibody fragment afelimomab in hyperinflammatory response during severe sepsis: The RAMSES Study. Crit Care Med 29:765–769CrossRef Reinhart K, Menges T, Gardlund B, Zwaveling JH, Smithes M, Vincent JL, Tellado JM, Salgado-Remigio A, Zimlichman R, Withington S, Tschaikowsky K, Brase R, Damas P, Kupper H, Kempeni J, Eiselstein J, Kaul M (2001) Randomized, placebo-controlled trial of the anti-tumor necrosis factor antibody fragment afelimomab in hyperinflammatory response during severe sepsis: The RAMSES Study. Crit Care Med 29:765–769CrossRef
12.
Zurück zum Zitat Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Tweeddale M, Schweitzer I, Yetisir E, the Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340:409–417CrossRef Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Tweeddale M, Schweitzer I, Yetisir E, the Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340:409–417CrossRef
13.
Zurück zum Zitat Gomersall CD, Joynt GM, Freebairn RC, Hung V, Buckley TA, Oh TE (2000) Resuscitation of critically ill patients based on the results of gastric tonometry. A prospective randomized controlled trial. Crit Care Med 28:607–614CrossRef Gomersall CD, Joynt GM, Freebairn RC, Hung V, Buckley TA, Oh TE (2000) Resuscitation of critically ill patients based on the results of gastric tonometry. A prospective randomized controlled trial. Crit Care Med 28:607–614CrossRef
14.
Zurück zum Zitat Barie PS, Hydo LJ, Fischer E (1996) Utility of illness severity scoring for prediction of prolonged surgical critical care. J Trauma 40:513–518CrossRef Barie PS, Hydo LJ, Fischer E (1996) Utility of illness severity scoring for prediction of prolonged surgical critical care. J Trauma 40:513–518CrossRef
15.
Zurück zum Zitat Cumming J, Purdue GF, Hunt JL, O’Keefe GE (2001) Objective estimates of the incidence and consequences of multiple organ dysfunction and sepsis after burn trauma. J Trauma 50:510–515CrossRef Cumming J, Purdue GF, Hunt JL, O’Keefe GE (2001) Objective estimates of the incidence and consequences of multiple organ dysfunction and sepsis after burn trauma. J Trauma 50:510–515CrossRef
16.
Zurück zum Zitat Gordon BR, Parker TS, Levine DM, Saal SD, Wang JCL, Sloan BJ, Barie PS, Rubin AL (2001) Relationship of hypolipidemia to cytokine concentrations and outcomes in critically ill surgical patients. Crit Care Med 29:1563–1568CrossRef Gordon BR, Parker TS, Levine DM, Saal SD, Wang JCL, Sloan BJ, Barie PS, Rubin AL (2001) Relationship of hypolipidemia to cytokine concentrations and outcomes in critically ill surgical patients. Crit Care Med 29:1563–1568CrossRef
17.
Zurück zum Zitat Pettila V, Pettila M, Sarna S, Voutilainen P, Takkunen O (2002) Comparison of multiple organ dysfunction scores in the prediction of hospital mortality in the critically ill. Crit Care Med 30:1705–1711CrossRef Pettila V, Pettila M, Sarna S, Voutilainen P, Takkunen O (2002) Comparison of multiple organ dysfunction scores in the prediction of hospital mortality in the critically ill. Crit Care Med 30:1705–1711CrossRef
18.
Zurück zum Zitat Jacobs S, Zuleika M, Mphansa T (1999) The Multiple Organ Dysfunction score as a descriptor of patient outcome in septic shock compared with two other scoring systems. Crit Care Med 27:741–744CrossRef Jacobs S, Zuleika M, Mphansa T (1999) The Multiple Organ Dysfunction score as a descriptor of patient outcome in septic shock compared with two other scoring systems. Crit Care Med 27:741–744CrossRef
19.
Zurück zum Zitat Cook R, Cook D, Tilley J, Lee K, Marshall J (2001) Multiple organ dysfunction: baseline and serial component scores. Crit Care Med 29:2046–2050CrossRef Cook R, Cook D, Tilley J, Lee K, Marshall J (2001) Multiple organ dysfunction: baseline and serial component scores. Crit Care Med 29:2046–2050CrossRef
20.
Zurück zum Zitat Oda S, Hirasawa H, Sugai T, Shiga H, Matsuda K, Ueno H (1998) Cellular injury score for multiple organ failure severity scoring system. J Trauma 45:304–310CrossRef Oda S, Hirasawa H, Sugai T, Shiga H, Matsuda K, Ueno H (1998) Cellular injury score for multiple organ failure severity scoring system. J Trauma 45:304–310CrossRef
21.
Zurück zum Zitat Timsit JF, Fosse JP, Troche G, De Lassence A, Alberti C, Garrouste-Org, Azoulay E, Chevret S, Moine P, Cohen Y (2001) Accuracy of a composite score using daily SAPS II and LOD scores for predicting hospital mortality in ICU patients hospitalized for more than 72 h. Intensive Care Med 27:1012–1021CrossRef Timsit JF, Fosse JP, Troche G, De Lassence A, Alberti C, Garrouste-Org, Azoulay E, Chevret S, Moine P, Cohen Y (2001) Accuracy of a composite score using daily SAPS II and LOD scores for predicting hospital mortality in ICU patients hospitalized for more than 72 h. Intensive Care Med 27:1012–1021CrossRef
22.
Zurück zum Zitat Timsit JF, Fosse JP, Troche G, De Lassence A, Alberti C, Garrouste-Org, Bornstain C, Adrie C, Cheval C, Chevret S (2002) Calibration and discrimination by daily Logistic Organ Dysfunction scoring comparatively with daily Sequential Organ Failure Assessment scoring for predicting hospital mortality in critically ill patients. Crit Care Med 30:2003–2013CrossRef Timsit JF, Fosse JP, Troche G, De Lassence A, Alberti C, Garrouste-Org, Bornstain C, Adrie C, Cheval C, Chevret S (2002) Calibration and discrimination by daily Logistic Organ Dysfunction scoring comparatively with daily Sequential Organ Failure Assessment scoring for predicting hospital mortality in critically ill patients. Crit Care Med 30:2003–2013CrossRef
23.
Zurück zum Zitat Bota DP, Melot C, Lopes FF, Nguyen BV, Vincent JL (2002) The Multiple Organ Dysfunction Score (MODS) versus the Sequential Organ Failure Assessment (SOFA) score in outcome prediction. Intensive Care Med 28:1619–1624CrossRef Bota DP, Melot C, Lopes FF, Nguyen BV, Vincent JL (2002) The Multiple Organ Dysfunction Score (MODS) versus the Sequential Organ Failure Assessment (SOFA) score in outcome prediction. Intensive Care Med 28:1619–1624CrossRef
Metadaten
Titel
Validation of the multiple organ dysfunction (MOD) score in critically ill medical and surgical patients
verfasst von
Thomas A. Buckley
Charles D. Gomersall
Sarah J. Ramsay
Publikationsdatum
01.12.2003
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 12/2003
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-2037-z

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