Objective To investigate the clinical characteristics and risk factors for death in the elderly patients with multiple organ dysfunction syndrome (MODSE) receiving long-term care and a combination of medical treatment and nursing care. Methods A retrospective study was conducted of 107 MODSE patients admitted to the Department of Geriatrics in Jianghan Oilfield General Hospital from January 2012 to July 2018, who were given a combination of medical treatment and nursing care. According to the outcome at day 28 after onset, the MODSE patients were divided into the survival group (n=34) and death group (n=73). The two groups were compared in the general clinical data, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, pulmonary infection score, Glasgow coma scale score of brain function and swallowing function score. SPSS statistics 17.0 was used for analysis, and t test or Chi-square test was applied for comparison between 2 guoups. Multivariate Cox regression was performed with statistically significant indices in the univariate analysis for independent risk factors affecting the mortality of MODSE patients. Results (1) Comparison of the general data found significant differences between the two groups in age, organ dysfunction number, systolic blood pressure, diastolic blood pressure, mean arterial pressure, partial pressure of carbon dioxide, oxygen partial pressure, oxygenation index, hemoglobin, albumin, fasting blood glucose, and blood urea nitrogen (P<0.01). (2) Comparison in the proportion of chronic diseases found significant differences between two groups in underlying diseases ≥4, chronic obstructive pulmonary disease (COPD), chronic heart failure, cerebrovascular disease, diabetes mellitus, dementia and cognitive impairment, pulmonary infection assessment scale≥6, Glasgow coma scale score, APACHE Ⅱ≥25, dysphagia grading scale ≤4, and lung, heart, kidney, brain and gastrointestinal insufficiency (P＜0.05). (3) Multivariate Cox regression showed that age, organ dysfunction number, APACHE Ⅱ score, Glasgowcoma scale score, pulmonary infection score and COPD, chronic heart failure, cerebrovascular disease and serum albumin were independent risk factors for death in the MODSE patients with long-term care. Conclusion Death is more likely in the elderly MODSE patients with a variety of underlying diseases accompanied with COPD, chronic heart failure, cerebrovascular disease, pulmonary infection, and low serum albumin, and early monitoring and prevention should be strengthened.