Association of Changes in Acute Gastrointestinal Injury Grade with Prognosis in Critically Ill Patients: A Prospective, Single-Center, Observational Study

Abstract

Ming Zhong,1,* Wen Xu,1,* Yuzhen Qiu,1 Lei Li,1 Hongping Qu,1 Erzhen Chen2 1Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China; 2Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongping QuDepartment of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197. Ruijin No.2 Road, Shanghai 200025, People’s Republic of ChinaEmail [email protected] ChenDepartment of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, People’s Republic of ChinaEmail [email protected]: To investigate the association between the change of acute gastrointestinal injury (AGI) grade and the outcome in critically ill patients.Methods: This was a prospectively observational study. All patients admitted in the ICU from October 2013 to June 2015, with the duration of ICU > 72 h and age > 18 years, were enrolled in this study. The AGI grade and gastrointestinal symptoms were evaluated during ICU stay following the 2012 ESICM recommendation. The ICU mortality, duration of ICU stay, mechanical ventilation (MV) use, vasoactive drug use, and continuous renal replacement therapy of patients were recorded accordingly.Results: A total of 320 patients were included, and 265 of them were diagnosed with AGI. The overall ICU mortality was 11.88%, while it was 13.58% in patients with AGI. In logistic regression analyses, the decreasing trend of AGI grade was identified as a protective factor for ICU death (odds ratio (OR), 0.484; 95% confidence interval (CI), 0.26– 0.90), while the max AGI grade was a risk factor (OR, 3.464; 95% CI, 2.71– 8.47) for ICU death.Conclusion: The changes of AGI grades in critically ill patients were associated with their clinical outcomes. The ICU-acquired AGI patients associated with longer ICU stay days.Keywords: acute gastrointestinal injury grade, ICU stay, critically ill patient, patient outcome, ICU death

Keywords

• acute gastrointestinal injury grade
• icu stay
• critically ill patient
• patient outcome
• icu death.