Clinical study on systemic inflammatory response syndrome and multiple organ dysfunction syndrome after severe trauma

Objective:To study the significance of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) after severe trauma.Methods:The clinical data of 335 SIRS cases and 128 MODS cases were analyzed.The injury severity scores (ISS) in all cases were exceeding 16.The patients of SIRS met at least two or more of the revised criteria for SIRS,including fever,hypothermia,tachypnea or abnormal white blood cell count.In addition,those of MODS met the criteria of multiple organ dysfunction and the sequential occurrence of functional insufficiency in two or more organs 24 hours after trauma.Results:Among the 355 cases,those who met two,three and four of the revised criteria for SIRS were 127 (35 8%),136 (38 3%) and 92 (25 9%) cases respectively.116 out of 335 patients (32 7%) died,among which 83 died of MODS (71 6%),including 12 (9 4%) who met two of criteria for SIRS,23 (16 9%) met three and 48 (52 2%) met four.Notable discrepancy existed between those who met two or three SIRS criteria and those who met four (all P 0 01).Within the 83 patients who died of MODS,16 (34 0%) died of dysfunction in two organs,25 (69 4%) in three organs,30 (90 9%) in four organs,and 12 (100 0%) in five or more.The other 33 (28 4%) died not of MODS.Conclusions:It is suggested that severe posttraumatic shock,infection and immunologic dysfunction might cause SIRS or even MODS,and compensatory antiinflammatory response syndrome (CARS) and mixed antagonistic response syndrome (MARS) might play an important role in the maintenance of the equilibrium of internal environment of the body.