Acute gastrointestinal injury in critically ill children: Impact on clinical outcome.
J Paediatr Child Health
; 58(4): 649-654, 2022 04.
Article
em En
| MEDLINE
| ID: mdl-34750905
ABSTRACT
AIM:
To estimate acute gastrointestinal injury (AGI) in critically ill children and association of its severity with mortality.METHODS:
In a prospective cohort study, critically ill children (1 month-18 years) were enrolled. Gastrointestinal symptoms over the first week of admission were classified into AGI grades 1 through 4, using a paediatric adaptation of European Society of Intensive Care Medicine AGI definitions. Performance of AGI grades in predicting 28-day mortality was evaluated.RESULTS:
Of 151 children enrolled, 71 (47%, 95% confidence interval (CI) 38.9-55.3%) developed AGI, with AGI grades 1, 2, 3 and 4 in 22.5%, 15.9%, 6.6% and 2%, respectively. The 28-day mortality progressively increased with AGI grade 0 (15%), 1 (35%), 2 (50%), 3 (70%), through 4 (100%), P < 0.001. Association of AGI grades with 28-day mortality was significant even after adjustment for disease severity, age and nutritional status (odds ratio (OR) = 2.152, 95% CI 1.455, 3.184). Among AGI grades, and paediatric logistic organ dysfunction-2 score components, cardiovascular (OR = 1.525, 95% CI 1.142, 2.037) and haematological (OR = 1.719, 95% CI 1.067, 2.772) components of paediatric logistic organ dysfunction-2 score and AGI grades (OR = 1.565, 95% CI 1.001, 2.449) showed significant association with 28-day mortality.CONCLUSIONS:
Nearly half of the critically ill children developed AGI. AGI grades were independently associated with increased mortality, and mortality progressively increased with AGI grade.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Estado Terminal
/
Gastroenteropatias
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article