University of Oulu

Jansson, M. M., Ohtonen, P., Syrjälä, H., & Ala-Kokko, T. (2021). Changes in the incidence and outcome of multiple organ failure in emergency non-cardiac surgical admissions: a 10-year retrospective observational study [JD]. Minerva Anestesiologica. https://doi.org/10.23736/S0375-9393.20.14374-8

Changes in the incidence and outcome of multiple organ failure in emergency non-cardiac surgical admissions : a 10-year retrospective observational study

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Author: Jansson, Miia M1; Ohtonen, Pasi P2; Syrjälä, Hannu P3;
Organizations: 1Research Group of Medical Imaging, Physics and Technology, Oulu University Hospital, University of Oulu, Oulu, Finland
2Division of Operative care, Oulu University Hospital, Medical Research Center Oulu, University of Oulu, Oulu, Finland
3Department of Infection Control, Oulu University Hospital, Oulu, Finland;
4Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe202101212309
Language: English
Published: Edizioni Minerva Medica, 2021
Publish Date: 2021-12-10
Description:

Abstract

Background: During the past decades, epidemiologic data of independent predictors of multiple organ failure (MOF), incidence, and mortality have changed. The aim of the study was to assess the potential changes in the incidence and outcomes of MOF during one decade (2008–2017). In addition, resource utilization was taken into account.

Methods: Patients were eligible for inclusion if they were adults, admitted to the ICU between January 1, 2008 and December 31, 2017, and had complete data sets regarding MOF. MOF was defined as organ failure separately with and without central nervous system (CNS) failure. The onset of MOF was defined as being early (≤48 h of ICU admission) and late (>48 h after ICU admission).

Results: Of a total of 13,270 patients enclosed in this study, 44.6% of the patients developed MOF with and 31.4% without CNS failure. MOF-related mortality decreased in patients with (adjusted IRR 0.972 [95% CI 0.948 to 0.996], p =0.022) and without (adjusted IRR 0.957 [95% CI 0.931 to 0.983], p =0.0013) CNS failure. In addition, the incidence (adjusted IRR 0.970 [95% CI 0.950 to 0.991], p =0.006) and mortality (adjusted IRR 0.968 [95% CI 0.940 to 0.996], p =0.025) of early-onset MOF decreased, while the incidence and mortality of late-onset MOF remained constant. The length of ICU (p =0.024) and hospital (p =0.032) stays decreased while the length of mechanical ventilation remained constant (p =0.41).

Conclusions: Despite all improvements in intensive care during the last decades, the incidence of lateonset MOF remains a resource-intensive, morbid, and lethal condition. More research on etiologies, signs of organ failure, and where and when to start treatment is needed to improve the prognosis of late-onset MOF.

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Series: Minerva anestesiologica
ISSN: 0375-9393
ISSN-E: 1827-1596
ISSN-L: 0375-9393
Volume: In press
DOI: 10.23736/S0375-9393.20.14374-8
OADOI: https://oadoi.org/10.23736/S0375-9393.20.14374-8
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Copyright information: © 2020 EDIZIONI MINERVA MEDICA.