Multiple organ failure (MOF) is a major cause of trauma mortality and morbidity. The role of surgical procedures in precipitating MOF remains unclear.

Data on timing and duration of surgery was collated on 491 consecutive patients admitted to a Major Trauma Centre, who survived more than 48 hours and required Intensive Care Unit admission. MOF was defined according to the Denver Post Injury MOF Score, where MOF can occur only later than 48 hours after injury to exclude physiological derangements resulting from inadequate resuscitation.

Overall, 268 patients (54.6%) underwent surgery within 48 hours of injury, with 110 (22.4%) requiring surgery within 6 hours of injury. Total mean intra-operative time (p=0.067) nor the need for an operation within the first 6 (p=0.069) or 48 hours (p=0.124) were associated with MOF development. Multivariate predictive modelling of MOF showed timing and duration of surgery had no significant predictive power for MOF development (Odds Ratio 0.72, 95% CI 0.47–1.10).

Despite previous indication that early surgical intervention can precipitate MOF, current surgical strategy does not appear to impact MOF development.