Multiple Organ Dysfunction in Elderly Trauma
For the first time there are 11 million people aged 65 or over in the UK and the Office for National Statistics suggests that this is the fastest growing age-group nationally. As people live longer, the number of older people suffering traumatic injury is increasing. In those who survive the initial period after major trauma, a significant proportion goes onto develop adverse events such as multiple organ dysfunction (MODS).
MODs occurs as a result of an exaggerated systemic inflammatory response following major tissue trauma, and reports suggest that MODS affects between a third and a half of trauma patients admitted to critical care. Many younger injured people who develop MODS will recover quickly, whereas older patients appear to suffer prolonged organ dysfunction, which is complicated by persistent immunosuppression, infectious episodes and other adverse events. MODS in older people is associated with increased mortality, characterised by late, indolent death. To date, the effect of trauma related MODS on longer term outcomes has not been described. It is not clear from the available international evidence if age-related characteristics or other factors such as frailty affect the development and severity of MODS. The epidemiology, burden and outcomes of MODS in UK trauma systems have not been reported.
MODET (Multiple Organ Dysfunction in Elderly Trauma) is a Pan London Trauma System prospective observational study, funded by the Dunhill Medical Trust. Patients will be enrolled from the four Major Trauma Centres (Royal London Hospital, St Marys Hospital, Kings College Hospital and St Georges Hospital) over a two year period.
MODET aims to:
- Identify the prevalence, severity and patterns of MODS in older patients (compared to younger controls)
- Determine predictors and risk factors of developing MODS for older patients (compared to younger controls)
- Identify age related characteristics that contribute to the development of MODS
- Examine the mode of mortality associated with MODS
- Analyse the relationship between MODS and longer-term recovery and quality of life for older patients (compared to younger controls)
March 2019 update
The MODET study has enrolled 1366 patients across the London trauma system. The study has finished it's recruitment phase and researchers are cleaning and locking the data.
Key Documents
Study sites, protocol and flow diagram
For further information please contact Dr Elaine Cole, Chief Investigator: e.cole@qmul.ac.uk
