Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
BMJ Open. 2019 Jun 27;9(6):e028237. doi: 10.1136/bmjopen-2018-028237.
Diarrhoea is a frequent concern in the intensive care unit (ICU) and is associated with prolonged mechanical ventilation, increased length of ICU stay, skin breakdown and renal dysfunction. However, its prevalence, aetiology and prognosis in the critically ill have been poorly studied. The primary objectives of this study are to determine the incidence, risk factors and consequences of diarrhoea in critically ill adults. The secondary objectives are to estimate the incidence of associated diarrhoea (CDAD) in ICU patients and to validate the Bristol Stool Chart and Bliss Stool Classification System characterising bowel movements in the ICU. Our primary outcome is the incidence of diarrhoea . Our secondary outcomes include: CDAD, ICU and hospital mortality and ICU and hospital length of stay.
This international prospective cohort study will enrol patients over 10 weeks in 12 ICUs in Canada, the USA, Poland and Saudi Arabia. We will include all patients 18 years of age and older who are admitted to the ICU for at least 24 hours and follow them daily until ICU discharge. Our primary outcome is the incidence of diarrhoea based on the WHO definition, during the ICU stay. Our secondary outcomes include: CDAD, ICU and hospital mortality and ICU and hospital length of stay. We will use logistic regression to identify factors associated with diarrhoea (as defined using WHO criteria) and the kappa statistic to measure agreement on diarrhoea rates between the WHO definition and the Bristol Stool Chart and Bliss Stool Classification System.
The protocol has been approved by the research ethics board of all participating centres. The diarrhoea interventions, consequences and epidemiology in the intensive care unit (DICE-ICU) study will generate evidence about diarrhoea and its frequency, predisposing factors and consequences, to inform critical care practice and future research.
Diarrhoea is a frequent clinical problem for hospitalised patients including those who are critically ill in the ICU. Diarrhoea can cause complications such as skin damage, dehydration and kidney problems. It is not clear how common diarrhoea is in the ICU, the factors that cause it or the best way for clinicians to assess it. The DICE-ICU study is an international prospective observational study to examine the frequency, risk factors and outcomes of diarrhoea during critical illness.
腹泻是重症监护病房（ICU）中常见的问题，与机械通气时间延长、ICU 住院时间延长、皮肤破裂和肾功能障碍有关。然而，其在危重病患者中的患病率、病因和预后仍研究甚少。本研究的主要目的是确定危重症成人腹泻的发生率、危险因素和后果。次要目标是估计 ICU 患者中相关腹泻（CDAD）的发生率，并验证用于 ICU 中描述粪便特征的布里斯托粪便图表和 Bliss 粪便分类系统的准确性。我们的主要结局是腹泻的发生率。我们的次要结局包括：CDAD、ICU 和医院死亡率以及 ICU 和医院住院时间。
这是一项国际前瞻性队列研究，将在加拿大、美国、波兰和沙特阿拉伯的 12 个 ICU 中进行，历时 10 周，纳入年龄在 18 岁及以上、入住 ICU 至少 24 小时的所有患者，并对他们进行每日随访直至 ICU 出院。我们的主要结局是 ICU 住院期间基于世界卫生组织（WHO）定义的腹泻发生率。我们的次要结局包括：CDAD、ICU 和医院死亡率以及 ICU 和医院住院时间。我们将使用逻辑回归来确定与腹泻（根据 WHO 标准定义）相关的因素，并使用 Kappa 统计来测量 WHO 定义与布里斯托粪便图表和 Bliss 粪便分类系统之间在腹泻发生率方面的一致性。
该方案已获得所有参与中心的研究伦理委员会的批准。“重症监护病房腹泻的干预、后果和流行病学（DICE-ICU）研究”将生成关于腹泻及其频率、易患因素和后果的证据，以为重症监护实践和未来的研究提供信息。
腹泻是住院患者，包括 ICU 中危重病患者的常见临床问题。腹泻可导致皮肤损伤、脱水和肾脏问题等并发症。目前尚不清楚 ICU 中腹泻的发生率、引起腹泻的因素以及临床医生评估腹泻的最佳方法。DICE-ICU 研究是一项国际前瞻性观察性研究，旨在研究危重病期间腹泻的频率、危险因素和结局。
