The Gastrointestinal Failure Score Of Application Value In Critically Ill Patients

Objective: The purpose of the study is through analyze the correlationbetween outcome and gastrointestinal function of critically ill patients whichto confirm if the gastrointestinal failure score can be used in critically illpatients.Methods:there were465adult patients older than18years admitted in ICUof Chenzhou first people’s Hospital and ICU length of stay more than24hoursfrom January1,2013to July1,2013.The variable records were sex, age,diagnosis, whether laparatomy was performed, the level of APACHEⅡ score andSOFA score of the first day, history of chronic patients, whether mechanicalventilation was used, LOS of ICU, LOS of hospital, duration of MV, the GIF scoreof the first day and the mean GIF score of the first three days, Gastrointestinalnutrition intake, hospital mortality,ICU acquired infection. StatisticalPackage for Social Sciences (version17.0) software was used for statisticalanalysis.Results: The rate of critical patients with gastrointestinal dysfunction inthe first day up to84.9%, When the patients were divided into two groups ofsurvival group and death group, comparative analysis of the GIF scores, therewere difference in clinical data between survival group and death group, andthe higher GIF score mean poor outcome. there were difference in patients groupwith different causes in the first day’s GIF score and the mean GIF score ofthe first three days, The GI group higher than the other groups(P<0.05)，butthere were no statistical significance between the others (P>0.05). When the patients were divided into two groups of without food intolerance group and withfood intolerance group in the first day, the GIF Score couldn’t show thepatients disease severity. Non primary gastrointestinal system disease patientsin the ICU on the first day of the existence of gastrointestinal dysfunctionwas analyzed, results in non primary gastrointestinal system disease in ICUpatients suggest that the severity of the disease, blood glucose level, bloodpressure level，based disease score, APACHEII score, SOFA score on the firstday had no statistical significance (p>0.05), and suggests the presence ofstatistics significance of length of stay in hospital，length of stay in ICU，and mortality of hospital (p<0.05). When the patients in ICU withgastrointestinal dysfunction on the first day were divided into two groups whichwith primary gastrointestinal dysfunction and secondary gastrointestinaldysfunction groups. The patients suffer from primary gastrointestinal systemdisease difine primary gastrointestinal dysfunction, the patients withoutprimary gastrointestinal system disease difine secondary gastrointestinaldysfunction. Results suggest that in ICU patients is whether with primarygastrointestinal system disease in the severity of the disease,the bloodpressure level, blood urea nitrogen, blood platelet level, basic disease score,APACHEII score, SOFA score of he first day, GIF score the first day and themean GIF score of the first three day were statistically significant (p<0.05),but the prognostic index include length of stay in ICU, length of stay in hospital,length of mechanical ventilation had statistical significance (p<0.05), but nosignificant in mortality (P>0.05);But if we divided the patients into twogroups of without food intolerance group and with food intolerance group in thefirst three days, then it did show the group patients with food intolerance hadmore serious diseases.The patients were divided into two groups of withoutintra-abdominal hypertension group and with intra-abdominal hypertension groupin the first day, it showed the IAH group had higher APACHEII score、higher SOFA score and higher mortality rate. When APACHEII score, SOFA score and meanGIF score were used as variable factors using Logistic regression analysis, themean GIF score had the same role with APACHEII score and the SOFA score was riskfactor of death in patients. The survival curve analysis showed the check forceof mean GIF score discriminant death patients the same as the APACHEII scoreand SOFA score.Conclusion: The rate of critical patients with gastrointestinaldysfunction is high， patients group with different causes in the first day’sGIF score and the mean GIF score of the three days were different, Using theGIF score for severity assessment should pay attention to the patient’s diseasetype. The GIF score high in patients with poor outcome. The patients with foodintolerance in the first three days had more serious diseases. The patients withIAH with bad outcome. The mean GIF score could be used as a risk factor of deathin patients. The mean GIF score had very good check force in discriminant deathpatients.