The assessing results comparison of the multiple organ failure severity in patients with polytrauma
DOI:
https://doi.org/10.32782/2077-6594/2025.1/14Keywords:
polytrauma, multiple organ failure, intensive care unit, uniorgan failure, hemodynamics, mortality, chronic heart failure, hypoxia, lactateAbstract
Purpose. To assess and compare the severity of organ failure in patients with polytrauma. To establish the current mortality rate from organ failure in a homogeneous population of critical patients with polytrauma. Materials and methods. Adult trauma patients admitted to intensive care units were evaluated prospectively. Patients were evaluated for organ failure, including organ dysfunction and disease severity scores. These included lung damage scores, APACHE II and III chronic pathology scores, ISS injury severity scores, and multiple organ dysfunction scores. Results. 120 patients with injuries who lived longer than 48 hours were admitted to the intensive care unit. The data were analyzed from 2017 to 2022. The mean APACHE II and APACHE III rates at hospitalization and the assessment of injury severity were 12.2; 22; 30.5; 22.7 and 19; 10. Insufficiency of one organ occurred in 68 patients (56.6 %), multiple organ failure – in 41 patients (34.2 %) and patients with absent organ pathology – 11 (9.2 %). All uniorgan failures were caused by respiratory failure. The mortality rate was 4.3 % with insufficiency of one organ system, 32 % with insufficiency of two, 67 % with three, and 90% with failure of four organ systems. A multi-step retrospective analysis was performed to determine which is associated with risk factors for organ failure: mechanism of injury, lactate after 24 hours, ISS, APACHE II, APACHE III, assessment of acute respiratory distress syndrome at hospitalization, assessment of multiple organ dysfunction at hospitalization, and total blood transfusions transfused in 24 hours. Conclusions. Mortality in uniorgan failure is low and is associated primarily with the patient’s main injuries, and not with organ failure. Mortality among patients with four or more organ system deficiencies remains high, approaching 90 %.
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