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危重症患者急性胃肠损伤分级变化与预后的相关性:一项前瞻性、单中心观察性研究

Association of Changes in Acute Gastrointestinal Injury Grade with Prognosis in Critically Ill Patients: A Prospective, Single-Center, Observational Study.

作者信息

Zhong Ming, Xu Wen, Qiu Yuzhen, Li Lei, Qu Hongping, Chen Erzhen

机构信息

Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.

Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.

出版信息

J Multidiscip Healthc. 2021 Feb 5;14:279-286. doi: 10.2147/JMDH.S291883. eCollection 2021.

Abstract

PURPOSE

To investigate the association between the change of acute gastrointestinal injury (AGI) grade and the outcome in critically ill patients.

METHODS

This was a prospectively observational study. All patients admitted in the ICU from October 2013 to June 2015, with the duration of ICU > 72 h and age >18 years, were enrolled in this study. The AGI grade and gastrointestinal symptoms were evaluated during ICU stay following the 2012 ESICM recommendation. The ICU mortality, duration of ICU stay, mechanical ventilation (MV) use, vasoactive drug use, and continuous renal replacement therapy of patients were recorded accordingly.

RESULTS

A total of 320 patients were included, and 265 of them were diagnosed with AGI. The overall ICU mortality was 11.88%, while it was 13.58% in patients with AGI. In logistic regression analyses, the decreasing trend of AGI grade was identified as a protective factor for ICU death (odds ratio (OR), 0.484; 95% confidence interval (CI), 0.26-0.90), while the max AGI grade was a risk factor (OR, 3.464; 95% CI, 2.71-8.47) for ICU death.

CONCLUSION

The changes of AGI grades in critically ill patients were associated with their clinical outcomes. The ICU-acquired AGI patients associated with longer ICU stay days.

摘要

目的

探讨危重症患者急性胃肠损伤(AGI)分级变化与预后的关系。

方法

这是一项前瞻性观察性研究。纳入2013年10月至2015年6月入住重症监护病房(ICU)、ICU住院时间>72小时且年龄>18岁的所有患者。根据2012年欧洲重症监护医学学会(ESICM)的建议,在患者ICU住院期间评估AGI分级和胃肠道症状。相应记录患者的ICU死亡率、ICU住院时间、机械通气(MV)使用情况、血管活性药物使用情况及持续肾脏替代治疗情况。

结果

共纳入320例患者,其中265例被诊断为AGI。ICU总体死亡率为11.88%,而AGI患者的死亡率为13.58%。在逻辑回归分析中,AGI分级的下降趋势被确定为ICU死亡的保护因素(比值比(OR),0.484;95%置信区间(CI),0.26 - 0.90),而最高AGI分级是ICU死亡的危险因素(OR,3.464;95%CI,2.71 - 8.47)。

结论

危重症患者AGI分级的变化与其临床预后相关。ICU获得性AGI患者的ICU住院天数更长。

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