Martin Padar1, Joel Starkopf2, Gerli Uusvel3, Annika Reintam Blaser4. 1. Department of Anaesthesiology and Intensive Care, University of Tartu, 50406 Tartu, Estonia; Department of Anaesthesiology and Intensive Care, Tartu University Hospital, L. Puusepa 8, 50406 Tartu, Estonia. Electronic address: Martin.Padar@kliinikum.ee. 2. Department of Anaesthesiology and Intensive Care, University of Tartu, 50406 Tartu, Estonia; Department of Anaesthesiology and Intensive Care, Tartu University Hospital, L. Puusepa 8, 50406 Tartu, Estonia. Electronic address: Joel.Starkopf@kliinikum.ee. 3. Department of Anaesthesiology and Intensive Care, Tartu University Hospital, L. Puusepa 8, 50406 Tartu, Estonia. Electronic address: Gerli.Uusvel@kliinikum.ee. 4. Department of Anaesthesiology and Intensive Care, University of Tartu, 50406 Tartu, Estonia; Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Lucerne Cantonal Hospital, Spitalstrasse, 6000 Lucerne, Switzerland. Electronic address: Annika.Reintam.Blaser@ut.ee.
Abstract
PURPOSE: Goal of this study was to describe incidence and outcome of gastrointestinal failure (GIF) in ICU patients, evaluate its additive role to SOFA score in mortality prediction and describe GIF according to etiology. MATERIALS AND METHODS: A retrospective study with prospective data collection was conducted in mixed adult ICU patients admitted 2004-2015. GIF was considered present if ≥3 of following 6 symptoms occurred in 1 day: maximum gastric residual volume ≥ 500 mL; absent bowel sounds; vomiting or regurgitation; diarrhea; suspected or radiologically confirmed bowel distension; gastrointestinal bleeding. Division into primary (gastrointestinal pathology causing GIF) and secondary (due to other conditions) GIF was made based on origin of syndrome. RESULTS: GIF developed in 413 (10.4%) of 3959 patients. Primary GIF occurred in 61.3% and secondary GIF in 38.7% of patients. Development of GIF was associated with longer mechanical ventilation, ICU stay and higher ICU, 30-day and 90-day mortality. Outcomes of patients with primary and secondary GIF were similar. All SOFA sub-scores and number of gastrointestinal symptoms on admission day independently predicted 90-day mortality. CONCLUSIONS: Gastrointestinal failure, independent of origin, is associated with worse ICU outcome. Similar to other organ failures included in SOFA score, GIF independently predicts mortality.
PURPOSE: Goal of this study was to describe incidence and outcome of gastrointestinal failure (GIF) in ICU patients, evaluate its additive role to SOFA score in mortality prediction and describe GIF according to etiology. MATERIALS AND METHODS: A retrospective study with prospective data collection was conducted in mixed adult ICU patients admitted 2004-2015. GIF was considered present if ≥3 of following 6 symptoms occurred in 1 day: maximum gastric residual volume ≥ 500 mL; absent bowel sounds; vomiting or regurgitation; diarrhea; suspected or radiologically confirmed bowel distension; gastrointestinal bleeding. Division into primary (gastrointestinal pathology causing GIF) and secondary (due to other conditions) GIF was made based on origin of syndrome. RESULTS: GIF developed in 413 (10.4%) of 3959 patients. Primary GIF occurred in 61.3% and secondary GIF in 38.7% of patients. Development of GIF was associated with longer mechanical ventilation, ICU stay and higher ICU, 30-day and 90-day mortality. Outcomes of patients with primary and secondary GIF were similar. All SOFA sub-scores and number of gastrointestinal symptoms on admission day independently predicted 90-day mortality. CONCLUSIONS:Gastrointestinal failure, independent of origin, is associated with worse ICU outcome. Similar to other organ failures included in SOFA score, GIF independently predicts mortality.
Authors: Shiv D Kale; Brittney N Mehrkens; Molly M Stegman; Bridget Kastelberg; Henry Carnes; Rachel J McNeill; Amy Rizzo; Saikumar V Karyala; Sheryl Coutermarsh-Ott; Jackie A Fretz; Ying Sun; Jonathan L Koff; Govindarajan Rajagopalan Journal: Front Immunol Date: 2020-06-26 Impact factor: 7.561