Outcome of Multiple Organ Dysfunction in Older Major Trauma Critical Care Patients in the Intensive Care Unit

Background: Elderly trauma patients in the ICU often face the critical complication of Multiple Organ Dysfunction Score (MODS). Age-related physiological changes, comorbidities, and impaired recovery mechanisms contribute to poorer outcomes. Recognizing how MODS affects this population's ability to survive is essential for enhancing critical care strategies. Objective: To evaluate the incidence, predictors, and outcomes of MODS in trauma patients aged 70 years and older, focusing on survival rates and key influencing factors. Methods: This prospective observational study focused on ICU patients aged 70 and older who underwent surgery between January 1 and June 1, 2024. The study tracked various factors such as the APACHE II score for severity, organ dysfunction, type of surgery, and frailty, which was assessed using the Clinical Frailty Scale and Modified Frailty Index. It also took into account comorbidities, ICU readmission, and whether the surgery was elective or emergency in analyzing survival outcomes. Results: No significant survival difference was found between the 60 patients aged 70 or older and their younger counterparts (p = 0.567). In contrast, non-survivors showed significantly higher frailty scores (p < 0.001) and more severe multi-organ dysfunction (p < 0.001). Increased mortality was linked to emergency surgery (p < 0.001), ICU readmission (p < 0.001), and diabetes (p = 0.02). The survival rate for patients who underwent elective surgery was 100%. Conclusion: MODS is a stronger predictor of mortality in elderly ICU trauma patients than chronological age. Diabetes, ICU readmission, and emergent surgeries significantly affect survival outcomes. Screening for frailty and optimizing perioperative care may improve patient outcomes.