Multiple organ dysfunction syndrome (MODS) is a systemic, dysfunctional inflammatory response that requires long intensive care unit (ICU) stay. It is characterized with high mortality rate depending on the number of organs involved. It has been recognized that organ failure does not occur as an all-or-none rule, but rather a range of organ dysfunction exists resulting in clinical organ failure. In the absence of a gold standard scoring or tool for early diagnosis or prediction of MODS, a novel bio-clinical scoring is mandatory. Moreover, understanding the pathophysiology of MODS in medical, surgical and trauma, ICUs should take a priority to achieve a favorable outcome. Herein we reviewed the literatures published in English language through the research engines (MEDLINE, Scopus, and EBASE) from 1982 to 2011 using key words: “multiorgan dysfunction”, “organ failure”, “intensive care units” to highlight the definition, mechanism, diagnosis and prediction of MODS particularly at its earliest stages. Bring up new bio-clinical scoring to a stage where it is ready for field trials will pave the way for implementing new risk-stratification strategy in the intensive care to reduce the morbidity and mortality and save resources. Prospective studies are needed to answer our question and to shift MODS from an inevitable to a preventable disorder.
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