Multiple Organ Dysfunction During Resuscitation Is Not Postinjury Multiple Organ Failure

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Abstract
Postinjury multiple organ failure (MOF) is a leading cause of late postinjury deaths and morbidity despite more than 25 years of intensive study.1-3 The etiology is proposed to be a result of uncontrolled systemic inflammation leading to secondary organ injury and dysfunction.4 Clinical manifestations can range from a mild systemic inflammatory response to overt organ failure. The initial magnitude of the postinjury inflammatory response is dependent on the amount of tissue injury, the degree of shock, and the presence of host factors such as age and comorbid disease. We developed an MOF scale in 1987 as a descriptive end point for clinical studies.5 A slightly modified scale (the Denver MOF scale) has since been used in generating predictive models of postinjury MOF based on early physiologic responses to injury and resuscitation.1,6,7 Our definition of MOF did not include organ dysfunction scores obtained within 48 hours of injury because it was thought that organ dysfunction during this period reflects reversible derangements induced by the inciting event or incomplete resuscitation.