Gastrointestinal Failure Score in Children with Traumatic Brain Injury
Background: To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function.
Methods: A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Pediatric Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined.
Results: The percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4% and 21.8% of the patients, respectively. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); these scores were also significantly different between patients who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children.
Conclusion: The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.
Figure 1
Posted 21 Jan, 2021
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Gastrointestinal Failure Score in Children with Traumatic Brain Injury
Posted 21 Jan, 2021
Invitations sent on 14 Jan, 2021
On 13 Jan, 2021
On 13 Jan, 2021
On 13 Jan, 2021
On 03 Jan, 2021
On 28 Dec, 2020
On 28 Dec, 2020
On 19 Dec, 2020
On 30 Nov, 2020
Received 29 Nov, 2020
On 08 Nov, 2020
Received 10 Aug, 2020
On 16 Jul, 2020
Invitations sent on 09 Jul, 2020
On 21 Jun, 2020
On 20 Jun, 2020
On 20 Jun, 2020
On 19 Jun, 2020
Background: To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function.
Methods: A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Pediatric Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined.
Results: The percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4% and 21.8% of the patients, respectively. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); these scores were also significantly different between patients who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children.
Conclusion: The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.
Figure 1