Prevalence and outcome of acute gastrointestinal injury in critically ill patients
Open Access
- 1 October 2018
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Medicine
- Vol. 97 (43), e12970
- https://doi.org/10.1097/md.0000000000012970
Abstract
The aim of the study was to investigate the prevalence and impact of acute gastrointestinal injury (AGI) on clinical outcomes in critically ill patients. The PubMed, Cochrane, and Embase databases were searched to identify trials that assessed gastrointestinal injury in critically ill patients. Outcome measures were prevalence of AGI among critically ill patients; incidence of mortality among critically ill patients with AGI, and incidence of mortality stratified by severity of AGI. The meta-analysis included 14 studies. The prevalence of AGI in critically ill patients was 40% [95% confidence interval (CI), 27%–54%]; the incidence of mortality among critically ill patients with AGI was 33% (95% CI, 26%–41%). There was a higher risk of mortality in critically ill patients with AGI compared to those without AGI [risk ratio (RR) = 2.01; 95% CI 1.20–3.37, P = .008). Subgroup analyses of studies that defined AGI according to European Society of Intensive Care Medicine (ESICM) criteria confirmed these findings and showed that the risk of mortality was higher in critically ill patients with more severe AGI (ESICM grade III and IV vs grade II) [RR of 1.86 (95% CI 1.48–2.34), P < .00001]. AGI is common in critically ill patients, mortality in critically ill patients with AGI is high, and severity of AGI is associated with mortality. The widespread clinical use of standard criteria with a severity gradation will facilitate the diagnosis and management of AGI in critically ill patients.Keywords
This publication has 22 references indexed in Scilit:
- Enterocyte Damage in Critically Ill Patients Is Associated With Shock Condition and 28-Day Mortality*Critical Care Medicine, 2013
- Impaired gastrointestinal transit and its associated morbidity in the intensive care unitJournal of Critical Care, 2013
- Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome: a prospective multicentre studyIntensive Care Medicine, 2013
- Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal ProblemsIntensive Care Medicine, 2012
- Gastrointestinal dysmotility is associated with altered gut flora and septic mortality in patients with severe systemic inflammatory response syndrome: a preliminary studyNeurogastroenterology & Motility, 2010
- The exact distribution of Cochran's heterogeneity statistic in one‐way random effects meta‐analysisStatistics in Medicine, 2008
- Gastrointestinal Failure score in critically ill patients: a prospective observational studyCritical Care, 2008
- Enteral nutrition-related gastrointestinal complications in critically ill patientsCritical Care Medicine, 1999
- Increased Intestinal Permeability Is Associated with the Development of Multiple Organ Dysfunction Syndrome in Critically Ill ICU PatientsAmerican Journal of Respiratory and Critical Care Medicine, 1998
- Gastrointestinal dysfunction among intensive care unit patientsCritical Care Medicine, 1987