Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome: a prospective multicentre study

• DOI: 10.1007/s00134-013-2831-1
• Publication Date: 2013-01-30T07:51:54Z
• Authors: Annika Reintam Bl...; Martijn Poeze; Manu L. N. G. Mal...; Martin Björck; Heleen M. Oudeman...; Joel Starkopf
• Keywords: Pain medicine

The study aimed to develop a gastrointestinal (GI) dysfunction score predicting 28-day mortality for adult patients needing mechanical ventilation (MV). 377 from 40 ICUs with expected duration of MV at least 6 h were prospectively studied. Predefined GI symptoms, intra-abdominal pressures (IAP), feeding details, organ and treatment documented on days 1, 2, 4 7. number simultaneous symptoms was higher in nonsurvivors each day. Absent bowel sounds bleeding the most significantly associated mortality. None alone an independent predictor mortality, but failure (GIF)—defined as three or more symptoms—on day 1 ICU independently threefold increased risk During first week ICU, GIF occurred 24 (6.4 %) (62.5 vs. 28.9 %, P = 0.001). Adding created subscore (based symptoms) SOFA did not improve prediction (day AUROC 0.706 [95 % CI 0.647–0.766] versus 0.703 0.643–0.762] alone). An increasing predicts 28 moderate accuracy. However, it possible score, improving performance either due data set limitations, definition problems, possibly indicating that is often secondary primary cause other failure.