Abstract: Objective To establish the database of old patients with multiple organ dysfunction syndrome（MODS） and to compare the efficiency of 4 currently available scoring systems in predicting the prognosis of old patients with MODSE. Methods A total of 206 patients with MODSE admitted to our hospital in 2009-2010 were enrolled in this study.Their prognosis was evaluated with the 4 scoring systems,known as APACHE II,APACHE III,SAPS II and MODS,respectively.The diagnostic efficiency of the 4 systems was compared. Results The mean age of 206 patients with MODSE（133 males and 73 females） was 75.40±7.84 years.The total mortality was 54.9%.The scores were significantly higher for non-survivors than for survivors（P＜0.001）.The score of APACHE II,APACHE III,SAPS II and MODS according to the area under the ROC curve was 0.825 7,0.847 2,0.849 4 and 0.818 4,respectively.The sensitivity of SAPS II was the highest,while the sensitivity of APACHE III was the best. Conclusion The 4 currently available scoring systems can predict the prognosis of old patients with MODSE with a rather good sensitivity and specificity.