Gastrointestinal Failure Is a Predictor of Poor Outcome in Patients with Acute Pancreatitis

Tang

2021

BMC Pediatr

Background To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function. Methods A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb), hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Pediatric Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined. Results The percentage of patients with gastrointestinal dysfunction on the first day was 78.8 %. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4 and 21.8 % of the patients, respectively. The GIF score and mean GIF score for the first three days were significantly different between children with different degrees of TBI (P < 0.05); these scores were also significantly different between patients who died and those who survived (P < 0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio > 1, 95 % confidence interval = 1.457 to 16.016, P < 0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children. Conclusions The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

Section: Discussionsupporting

confidence: 90%

Gastrointestinal failure score in children with traumatic brain injury

Tang

2021

BMC Pediatr

“…In this study, 135 children with TBI (78.8%) had gastrointestinal dysfunction on the rst day of admission, suggesting that gastrointestinal dysfunction in children with TBI is very common. The incidence of stress ulcers in children with TBI was 48.5% and gradually increased with TBI severity, with a rate of 85.9% in severe cases, suggesting that the risk of gastrointestinal mucosal ischemia is high, which is consistent with previous reports in adult TBI patients [10]. The gastrointestinal tract is the only system that is jointly controlled by the central nervous system, enteric nerves, and autonomic nerves; thus, the complex neuroendocrine network named the brain-gut axis plays an important role in regulating gastrointestinal function.…”

Section: Discussionsupporting

confidence: 90%

“…The GIF score re ects gastrointestinal function, which can be classi ed into different levels similar to other scoring systems for organ function failure. The clinical value and high reliability of the GIF score for predicting outcomes has been veri ed in intensive care patients and in digestive system diseases [10,16,22]. Although the GIF score can be used as an independent risk factor for predicting the risk of death in critically ill patients [23], it focuses on gastrointestinal function at the time of injury.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Lü

Tang³

2021

Preprint

Purposes: To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function. Methods: A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were retrospectively analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined. Results: The percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4% and 21.8% of the patients, respectively. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); these scores were also significantly different between patients who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children. Conclusion: The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

“…In this study, children with TBI (78.8%) had gastrointestinal dysfunction on the rst day of admission, suggesting that gastrointestinal dysfunction in children with TBI is very common. The incidence of stress ulcers in children with TBI was 48.5% and gradually increased with TBI severity, with a rate of 85.9% in severe cases, suggesting that the risk of gastrointestinal mucosal ischemia is high, which is consistent with previous reports in adult TBI patients [10]. The gastrointestinal tract is the only system that is jointly controlled by the central nervous system, enteric nerves, and autonomic nerves; thus, the complex neuroendocrine network named the brain-gut axis plays an important role in regulating gastrointestinal…”

Section: Discussionsupporting

confidence: 90%

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Lü

Tang

2021

Preprint

Background: To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function. Methods: A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Pediatric Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined. Results: The percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4% and 21.8% of the patients, respectively. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); these scores were also significantly different between patients who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children. Conclusion: The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.