Epidemiology
Much of our understanding of the epidemiology of MODS comes from the work of
William Knaus and colleagues using the APACHE scoring systems at George
Washington University [6]. Their work has given rise to a more consistent method of
quantifying organ dysfunction and patient outcome associated with MODS. The criteria
developed by Knaus et al. define failure for six systems: respiratory, cardiovascular,
renal, hematologic, neurologic, and hepatic (see Table 1). From an epidemiologic perspective,
we now know that risk factors associated with the development of MODS in
decreasing order of importance include: 1) severe illness at the time of ICU admission
(the essence of the APACHE scoring system), 2) diagnosis of sepsis or infection at the
time of ICU admission, and 3) age of the patient.