الفهرس 
Epidemiology of MODSOnly 14 pages are availabe for public view
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Abstract
Multiple organ dysfunction is one of the leading causes of death in intensive care unit ( ICU ) patients.A number of inflammatory cells and mediators involved in the inflammatory response have been assessed for their role as potential markers of the presence and severity of the inflammatory response and organ failure.
CRP is predominantly produced and secreted by hepatocytes, although other cells including alveolar macrophages may also synthesize CRP. CRP is thought to represent a measure of cytokine-induced protein synthesis. Due to the fast rise in CRP concentrations, critically ill patients will often already have raised CRP levels on ICU admission. The relatively short half life of appropriately 19 hour makes it a useful monitor for follow up of inflammatory response, infection, and antibiotic treatment. In addition, laboratory tests for CRP are easily available and less costly than cytokine tests.
Previous reports have reported CRP levels to be a prognostic index in different entities, including ischemic stroke, acute pancreatitis, IgA nephropathy, terminal renal failure, and cardiovascular diseases.
Lobo et al. (2005), demonstrated the relation between CRP concentration and the severity and pattern of multiple organ dysfunction in ICU patients, they concluded that CRP levels are good early marker if morbidity and mortality in these patients. In addition, CRP concentrations may be a valuable addition to APACHE II scors to predict the risk of death as the APACHE scors for all three groups was similar as ICU seems yet there were more death in the group with higher CRP levels than in the other two groups.
Serial measures of CRP concentration in critically ill patients may help to identify patients who may require more aggressive diagnostic, therapeutic interventions to avoid complications.
In our study, we tried to correlate level of CRP with mortality and organ failure in critically ill patients.
During a six month period from September 2004 to February 2005, we prospectively studied 41 patients randomly admitted to the RICU excluding those patients with Rheumatic fever, collagen diseases e.g. (rheumatoid arthritis, systemic lupus erythrematosis) and recent myocardial infarction.
Data analysis revealed that of 41 patients included in our study, 25 were males (61%), 16 were females (39%) with a mean age of 56.17 years (range 28-84 years).
They were divided into 2 groups according to their CRP level on admission:
CRP level > 10 mg/dl group 1 (34 patients)
CRP level < 10 mg/dl group 2 (7 patients)
We found that higher mortality, multiple organ failure and mechanical ventilation were more associated with patients who CRP levels more than 10mg/dl on admission with predominence of respiratory, renal and cardio-vascular failure.with no significance of CRP on day 5.
We also found that CRP was a good positive test in prediction of mortality and also increased during minor severity of organ dysfunction but did not further increase during more severe stages of the disease.