Ventilator-associated pneumonia and multiple organ failure in the elderly

Objective：To investigate the clinical progress and characteristics of the ventilator-associated pneumonia （VAP） complicated multiple organ failure in the elderly （MOFE）.To evaluate the clinical value of multiple organ dysfunction score （MODS） as a predictor of the prognosis.Methods：A prospective clinical trial in 145consecutive VAP episodes of 67patients receiving mechanical ventilation was made.The incidence，clinical characteristics and outcom of the patients with VAP complicated MOFE were analysed.The correlation between the MODS and the prognosis was evaluated.Results：134episodes of VAP complicated MOFE （incidence 92.4%），of them，34patients died （fatality rate 25.4%）.Single-phase type （typeⅠ） and double-phase type （typeⅡ） were the most of ten types of MOFE episodes.The fatality rate in VAP patients complicated typeⅡ MOFE was higher than that in typeⅠ.The fatality rates were 0， 18.3%，45.9% and 100% in VAP patients complicated MOFE with MODS0～4，5～8，9～12 and more than 12，and were 0， 20.8%，56.5% and 100% in VAP patients with 2，3，4 and more than 4failure organ，respectively，which differences were statistically significance.Conclusion：VAP is an important initiative cause of the MOFE episodes.The patients with VAP complicated MOFE have characteristic clinical progress and outcome.A significant positive correlation is found between the MODS，number of the organ failure and the fatality rate.As good a predictor （cutoff point =9），MODS may be used to estimate the prognosis of patients with VAP complicated MOFE.