The characteristics of multiple organ failure during the war in Croatia

The war in Croatia resulted in a significant change in the pattern of morbi dity and mortality in both the surgical and the medical domains. With the o nset of the wr, the most common causes of hospitalization became wr-related injuries and their septic complications. During the war in Croatia, we fou nd a higher incidence of multiple injuries (gunshot wounds, shrapnel, and g renade injuries), as well as an increase in the occurrence of infectious di seases transmitted by rodents. Many of thee polytraumatized patients develo ped organ failure secondary to their war-related trauma, with a ver poor pr ognosis. Renal failure was, in this setting, mostly only a component of mul tiple organ failure. Some infectious disorders, such as hemorrhagic fever a nd leptospirosis, were responsible for the higher frequency of acute renal failure (ARF) that we have documented in the war setting. Patients who deve loped ARF due to infectious diseases unrelated to trauma had a different pr ognosis. Patients who developed ARF as a complication of leptospirosis had a good prognosis. ARF caused by the Hantaan virus usually ran a benign cour se (with some exceptions) in both its oliguric and nonoliguric forms. Altho ugh ARF is usually of a multifactorial genesis, our study aimed to emphasiz e the importance of disseminated septic processes as a cause of ARF.