The Clinical Study On Multiple Organ Failure In The Elderly

Objective : To reveal the clinical features and risk factors of prognosis of multiple organ failure in the elderly (MOFE) , and thus can provide theoretical and clinical basis for further study and therapy in MOFE .Methods : 207 patients with MOFE were analyzed retrospectively from 1994 to 2000 , all were treated at the emergency center of Tian Jin Medical University General Hospital . The questionnaire included patient's age , sex , primary chronic diseases , precipitating factors , the first and multiple failed organs , number of failed organs , clinical patterns and stages , life sign and laboratory examination , treatment . prognosis and so on . Then , the data were collected according to each element studied . the comparable data were statistically analyzed , educed results , and draw a conclusion .Results : The morbidity and mortality of MOFE patients hadn't significantly difference from 1994 to 2000 . The main precipitating factors were pulmonary infection , acute attack of chronic cardiac or cerebral vascular diseases , the rates were 53.6% and 16.4% respectively. MOFE patients had many chronic diseases before they fell MOFE , 2.4 on the average and 6 at the most , the sequence of organ failure was heart , lung , brain , stomach and bowel , kidney , liver , blood , and the sequence of the first and multiple failed organs were same as that of their chronic diseases. The mortality increased gradually , following age increased and the number of failed organs rose (P<0.05) . The rapid pattern with single phase was the most common (79.2%) , the recurrent pattern with multiple phases was a peculiarity of MOFE , the mortality hadn't significantly difference among each pattern (P>0.05) . To clinical stage, most failed organs of the survivors were stage II ( failure compensation stage ) , among nosurvivors , the failed organs were3ABSTRACTmore in stage III ( failure decompensation stage ), there was significantlydifference between two groups (P<0.05) . The risk factors of prognosis includedAPACHEII , the number and kinds of failed organs , acid-base disturbances,severe sepsis or septic shock (PO.10). The nutritional support and immuneregulation hadn't improved prognosis.Conclusion : MOFE have its own characteristics in many aspects , such asprecipitating factors , primary chronic diseases , the sequence of failed organs ,clinical patterns , curative effect and so on . Prevention of risk factors maydecrease the mortality of MOFE.