Comparing gastrointestinal dysfunction score and acute gastrointestinal injury grade for predicting short-term mortality in critically ill patients.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

World Journal of Gastroenterology Pub Date : 2024-11-14 DOI:10.3748/wjg.v30.i42.4523

Chao Shen, Xi Wang, Yi-Ying Xiao, Jia-Ying Zhang, Guo-Lian Xia, Rong-Lin Jiang

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Abstract

Background: The prognosis of critically ill patients is closely linked to their gastrointestinal (GI) function. The acute GI injury (AGI) grading system, established in 2012, is extensively utilized to evaluate GI dysfunction and forecast outcomes in clinical settings. In 2021, the GI dysfunction score (GIDS) was developed, building on the AGI grading system, to enhance the accuracy of GI dysfunction severity assessment, improve prognostic predictions, reduce subjectivity, and increase reproducibility.

Aim: To compare the predictive capabilities of GIDS and the AGI grading system for 28-day mortality in critically ill patients.

Methods: A retrospective study was conducted at the general intensive care unit (ICU) of a regional university hospital. All data were collected during the first week of ICU admission. The primary outcome was 28-day mortality. Multivariable logistic regression analyzed whether GIDS and AGI grade were independent risk factors for 28-day mortality. The predictive abilities of GIDS and AGI grade were compared using the receiver operating characteristic curve, with DeLong's test assessing differences between the curves' areas.

Results: The incidence of AGI in the first week of ICU admission was 92.13%. There were 85 deaths (47.75%) within 28 days of ICU admission. There was no initial 24-hour difference in GIDS between the non-survival and survival groups. Both GIDS (OR 2.01, 95%CI: 1.25-3.24; P = 0.004) and AGI grade (OR 1.94, 95%CI: 1.12-3.38; P = 0.019) were independent predictors of 28-day mortality. No significant difference was found between the predictive accuracy of GIDS and AGI grade for 28-day mortality during the first week of ICU admission (Z = -0.26, P = 0.794).

Conclusion: GIDS within the first 24 hours was an unreliable predictor of 28-day mortality. The predictive accuracy for 28-day mortality from both systems during the first week was comparable.

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比较胃肠功能紊乱评分和急性胃肠损伤分级，以预测重症患者的短期死亡率。

背景：危重病人的预后与胃肠道（GI）功能密切相关。2012 年建立的急性胃肠道损伤（AGI）分级系统被广泛用于评估胃肠道功能障碍和预测临床预后。目的：比较 GIDS 和 AGI 分级系统对重症患者 28 天死亡率的预测能力：方法：在一家地区性大学医院的普通重症监护室（ICU）进行了一项回顾性研究。所有数据都是在重症监护室入院第一周收集的。主要结果是 28 天的死亡率。多变量逻辑回归分析了 GIDS 和 AGI 分级是否是 28 天死亡率的独立风险因素。使用接收者操作特征曲线比较了GIDS和AGI分级的预测能力，并用DeLong检验评估了曲线面积之间的差异：结果：入住重症监护室第一周的 AGI 发生率为 92.13%。入住重症监护室 28 天内有 85 人死亡（47.75%）。非存活组和存活组的 GIDS 在最初 24 小时内没有差异。GIDS（OR 2.01，95%CI：1.25-3.24；P = 0.004）和 AGI 分级（OR 1.94，95%CI：1.12-3.38；P = 0.019）都是 28 天死亡率的独立预测因子。GIDS 和 AGI 分级对入住 ICU 第一周内 28 天死亡率的预测准确性无明显差异（Z = -0.26，P = 0.794）：结论：头24小时内的GIDS对28天死亡率的预测并不可靠。结论：最初 24 小时内的 GIDS 对 28 天死亡率的预测并不可靠，两种系统对入院第一周内 28 天死亡率的预测准确性相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

7.80

自引率

4.70%

发文量

464

审稿时长

2.4 months

期刊介绍： The primary aims of the WJG are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in gastroenterology and hepatology.