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



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

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


GI Function


AGI Grade


none needed


self-limited condition

may improve function


dysfunction present

may improve function


failure present

cannot restore function


failure that is immediately life-threatening





• 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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