Sun et al modified the Gastrointestinal Failure (GIF) score of Reintam et al. The authors are from Nanjing Medical University in China.
Patient selection: severe acute pancreatitis, evaluated during the first 3 days in the ICU
Parameters:
(1) number of symptoms associated with food intolerance (nausea, vomiting, high gastric residual volumes, abdominal pain, abdominal distension, diarrhea)
(2) intra-abdominal pressure in mm Hg
(3) serum endotoxin concentration in pg/mL (Gold Mountainriver Technology Development Corporation, Limited)
(4) CT imaging findings
|
Parameter
|
Finding
|
Points
|
|
symptoms of food intolerance
|
none
|
0
|
|
|
1 or 2
|
1
|
|
|
>= 3
|
2
|
|
intra-abdominal pressure
|
< 12 mm Hg
|
0
|
|
|
12 to 20 mm Hg
|
1
|
|
|
> 20 mm Hg
|
2
|
|
|
abdominal compartment syndrome
|
2
|
|
endotoxin concentration
|
< 10 pg/mL
|
0
|
|
|
10 to 50 pg/mL
|
1
|
|
|
> 50 pg/mL
|
2
|
|
CT findings
|
normal
|
0
|
|
|
bowel wall thickening OR intestinal extension
|
1
|
|
|
bowel wall thickening AND intestinal extension
|
2
|
where:
• Bowel wall thickening is a wall thickness >= 3 mm.
• Intestinal extension is a dilatation > 2.5 cm in CT images.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
|
Total Score
|
Risk Group
|
|
0 or 1
|
low
|
|
2 to 4
|
intermediate
|
|
5 to 8
|
high
|
Performance:
• The area under the ROC curve was 0.92 for in-hospital mortality, 0.83 for MODS and 0.80 for pancreatic infection.
