FREQUENCY OF MULTIORGAN DYSFUNCTION SYNDROME (MODS) ON DAY 0 IN PATIENTS ADMITTING TO PICU AND ITS ASSOCIATION WITH RISK FACTORS FOR MORTALITY

Background: Multiorgan dysfunction syndrome (MODS) has been recognized as a leading contributor to death and disability in the PICU. Several definitions have been discussed in multiple studies. Objective: This study aims to evaluate the current incidence of MODS using Pediatric Organ Dysfunction Information Update Mandate 2022 (PODIUM) on Day 0 of admission to PICU and its associations with risk factors for mortality. Study design: It was a prospective descriptive study. Setting: The study was conducted in children (age:1mo-15yrs) admitted to the PICU of Children Hospital, Korangi, Karachi. Duration of study: The study was conducted over 6 months, from December 2024 to May 2025. Methods: A total of 396 patients were eligible for the study. Data collection was conducted using demographic data (age, gender), pertinent clinical variables, and the presence or absence of MODS as an outcome and disposition as either alive or expired. Logistic regression was applied for the assessment of risk factors of mortality in the presence of MODS. Results: A total of 396 patients were eligible for the study. Median age IQR was 9(5-24) and male gender 60.1%(n=238). The most common diagnostic category was sepsis (56.3%). PODIUM was observed in 34%(n=134). The frequency of Respiratory, Cardiovascular, and Neurologic dysfunction was reported to be 68.2%, 29%, and 20.7% respectively. The most common diagnostic category was sepsis (56.3%). The most common system contributing to mortality was cardiovascular, followed by neurologic. The use of vasoactive drugs and mechanical ventilation is one of the predictors of mortality on multivariate logistic regression analysis. The overall mortality was 8.3% and the case fatality rate was 21.6% (29/134). Conclusion: The incidence of PODIUM on day 0 was one-third of patients in our cohort. It was also observed that higher mortality is associated with >3 organ involvement.