Acute gastrointestinal injury in the intensive care unit: a retrospective study

被引:27
作者
Chen, HuaiSheng [1 ]
Zhang, HuaDong [1 ]
Li, Wei [1 ]
Wu, ShengNan [1 ]
Wang, Wei [2 ]
机构
[1] Jinan Univ, Shenzhen Peoples Hosp, Affiliated Hosp 2, Intens Care Unit, Shenzhen 518020, Guangdong, Peoples R China
[2] Jinan Univ, Shenzhen Peoples Hosp, Affiliated Hosp 2, Endocrinol Dept, Shenzhen 518020, Guangdong, Peoples R China
关键词
critical care; acute gastrointestinal injury; mortality; ORGAN DYSFUNCTION SYNDROME; SEVERE ACUTE-PANCREATITIS; BACTERIAL TRANSLOCATION; BARRIER DYSFUNCTION; MOTILITY; ILLNESS;
D O I
10.2147/TCRM.S92829
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Acute gastrointestinal injury (AGI) is a common problem in the intensive care unit (ICU). This study is a review of the gastrointestinal function of patients in critical care, with the aim to assess the feasibility and effectiveness of grading criteria developed by the European Society of Intensive Care Medicine (ESICM) Working Group on Abdominal Problems (WGAP). Methods: Data of patients who were admitted to the ICU of Shenzhen People's Hospital, Shenzhen, People's Republic of China, from January 2010 to December 2011 were reviewed. A total of 874 patients were included into the current study. Their sex, age, ICU admissive causes, complication of diabetes, AGI grade, primary or secondary AGI, mechanical ventilation (MV), and length of ICU stay (days) were recorded as risk factors of death. These risk factors were studied by unconditioned logistic regression analysis. Results: All the risk factors affected mortality rate. Unconditional logistic regression analysis revealed that the mortality rate of secondary AGI was 71 times higher than primary AGI (odds ratio [OR] 4.335, 95% CI [1.652, 11.375]). When the age increased by one year, the mortality probability would increase fourfold. Mortality in patients with MV was 63-fold higher than for patients with non-MV. Mortality rate increased 0.978 times with each additional day of ICU stay. Conclusion: Secondary AGI caused by severe systemic conditions can result in worsened clinical outcomes. The 2012 ESICM WGAP AGI recommendations were to some extent feasible and effective in guiding clinical practices, but the grading system lacked the support of objective laboratory outcomes.
引用
收藏
页码:1523 / 1529
页数:7
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