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Impact of Acute Gastrointestinal Injury (AGI) Grade and Feeding Intolerance on Mortality of a Patient in the Intensive Care Unit (ICU)

Description

Hu et al studied the impact of gastrointestinal injury on mortality of patients in the intensive care unit. A patient with evidence of acute gastrointestinal injury may have increased mortality. The authors are from Zhejiang Provincial People's Hospital in Hangzhou, Cina


Patient selection: in the ICU

 

Parameters:

(1) acute gastrointestinal injury (AGI) grade on first day of ICU admission

(2) feeding intolerance during the first week in the ICU

 

GI Function

Intervention

AGI Grade

normal

none needed

0

self-limited condition

may improve function

I

dysfunction present

may improve function

II

failure present

cannot restore function

III

failure that is immediately life-threatening

 

IV

 

where:

• Dysfunction is when the GI tract is not able to perform digestion and absorption sufficient to satisfy the nutrition and fluid requirements of the body.

• Failure is a loss of function with feeding intolerance, GI paralysis, bowel dilatation and increased intra-abdominal pressure.

 

For patients who were alive at 7 days the odds ratio for 60 day mortality was:

(1) for AGI Grade III or IV: 1.8

(2) for feeding intolerance during the first week: 1.8

 

Additional risk factors for mortality were the following determined during the first 24 hours in the ICU: need for vasoactive drugs, an elevated serum lactate and an elevated APACHE II score.


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