MODS on Day 1 is a Major Source of Mortality in the PICU

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Multiple Organ Dysfunction Syndrome (MODS) present on Day 1 of admission continues to be a major source of morbidity and mortality in the PICU, but risk of poor neurologic outcome may be improved.

Further research is needed to understand decisions regarding limitation of support and withdrawal of life-sustaining therapy decisions in patients admitted with day 1 Multiple Organ Dysfunction Syndrome.

Overall, PICU mortality was 2.1%. We identified day 1 Multiple Organ Dysfunction Syndrome in 14.4% of admissions.

Patients with Multiple Organ Dysfunction Syndrome had higher mortality than those without Multiple Organ Dysfunction Syndrome, and a higher percentage of survivors had greater than or equal to 2 category worsening in Pediatric Cerebral Performance Category score or Pediatric Overall Performance Category score.

The odds of death with day 1 Multiple Organ Dysfunction Syndrome was 14.3, while the odds of death or discharge with Pediatric Overall Performance Category/Pediatric Cerebral Performance Category score greater than or equal to 3 (poor functional outcome) was 6.7.

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