Huang Chun-Ta, Hong Chun-Ming, Tsai Yi-Ju, Sheng Wang-Huei, Yu Chong-Jen
Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.
Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan.
BMC Gastroenterol. 2020 Nov 16;20(1):383. doi: 10.1186/s12876-020-01537-z.
Development of gastrointestinal (GI) complications is adversely associated with prognosis in the critically ill. However, little is known about their impact on the outcome of non-critically ill patients. In this study, we aimed to investigate the incidence of GI complications and their influence on prognosis of hospitalized pneumonia patients.
Adult patients admitted with a diagnosis of pneumonia from 2012 to 2014 were included. Medical records were reviewed to obtain patients' demographics, physical signs, comorbidities, laboratory results, clinical events, and the Confusion, Urea, Respiratory rate, Blood pressure and age ≥ 65 (CURB-65) score was calculated to assess the severity of pneumonia. GI complications, including bowel distension, diarrhea, GI bleeding and ileus, were evaluated during the first 3 days of hospitalization and their association with patient outcomes, such as hospital mortality and length of stay, was analyzed.
A total of 1001 patients were enrolled, with a mean age of 73.7 years and 598 (59%) male. Among them, 114 (11%) patients experienced at least one GI complication and diarrhea (5.2%) was the most common. The hospital mortality was 14% and was independently associated with an increase in the CURB-65 score (odds ratio [OR] 1.952 per point increase; 95% confidence interval [CI] 1.516-2.514), comorbid malignancy (OR 1.943; 95% CI 1.209-3.123), development of septic shock (OR 25.896; 95% CI 8.970-74.765), and the presence of any GI complication (OR 1.753; 95% CI 1.003-3.065).
Compared to a critical care setting, GI complications are not commonly observed in a non-critical care setting; however, they still have a negative impact on prognosis of pneumonia patients, including higher mortality and prolonged length of hospital stay.
胃肠道（GI）并发症的发生与危重症患者的预后呈负相关。然而，对于它们对非危重症患者结局的影响知之甚少。在本研究中，我们旨在调查GI并发症的发生率及其对住院肺炎患者预后的影响。
纳入2012年至2014年因肺炎诊断入院的成年患者。查阅病历以获取患者的人口统计学资料、体征、合并症、实验室检查结果、临床事件，并计算意识障碍、尿素、呼吸频率、血压和年龄≥65岁（CURB-65）评分以评估肺炎的严重程度。在住院的前3天评估GI并发症，包括肠扩张、腹泻、GI出血和肠梗阻，并分析它们与患者结局（如医院死亡率和住院时间）的关联。
共纳入1001例患者，平均年龄73.7岁，男性598例（59%）。其中，114例（11%）患者至少发生一种GI并发症，腹泻（5.2%）最为常见。医院死亡率为14%，且与CURB-65评分增加（每增加1分，比值比[OR]为1.952；95%置信区间[CI]为1.516 - 2.514）、合并恶性肿瘤（OR为1.943；95% CI为1.209 - 3.123）、发生感染性休克（OR为25.896；95% CI为8.970 - 74.765）以及存在任何GI并发症（OR为1.753；95% CI为1.003 - 3.065）独立相关。
与重症监护环境相比，GI并发症在非重症监护环境中并不常见；然而，它们仍然对肺炎患者的预后有负面影响，包括更高的死亡率和更长的住院时间。
