Weiler et al developed a multi-organ dysfunction score (MODS) based on 14 organ systems to evaluate patients in the intensive care unit. This can help determine the overall severity of a patient's illness. The authors are from Dr Horst-Schmidt-Kliniken in Wiesbaden.
Patient evaluation is based on the first 24 hours after admission to the ICU.
Primary organ systems (10):
(1) heart (heart failure, myocardial infarction)
(2) blood vessels (shock, hypertension, ischemia)
(3) blood (anemia, thrombocytopenia)
(4) respiratory system (respiratory distress, respiratory failure)
(5) metabolism (abnormal electrolytes, malnutrition, hypoalbuminemia)
(6) gastrointestinal tract (nausea, vomiting, diarrhea, abdominal pain, diarrhea)
(7) liver (elevated serum bilirubin, liver function tests)
(8) kidney and urinary tract (elevated serum BUN and creatinine)
(9) immune system (immunodeficiency, anaphylaxis, autoimmune)
(10) central nervous system (headache, Glasgow coma score, convulsions)
Optional organ systems (4):
(11) skin
(12) bone
(13) connective tissue
(14) peripheral nervous system
Each organ system is graded on a 5 point scale depending on disease severity and response to therapy.
|
Disease Severity
|
Response to Therapy
|
Points
|
|
none (normal)
|
NA (no therapy required)
|
1
|
|
mild to moderate
|
responds to standard therapy
|
2
|
|
moderate to severe
|
responds to maximal therapy
|
3
|
|
severe
|
failure to completely respond to maximal therapy
|
4
|
|
very severe
|
progressive disease despite maximal therapy
|
5
|
total score =
= SUM(points for all organ systems evaluated)
Interpretation:
• minimum score for 14 organ systems: 14
• maximum score for 14 organ systems: 70
• The higher the score the more severe the patient's condition.
• The number of organ systems that are severe or very severe are also significant.
