Comparing Gastrointestinal Dysfunction Score and Acute Gastrointestinal Injury Grade for Predicting Short-term Mortality in Critically Ill Patients

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2024 Nov 20

PMID 39563745

Authors

Chao Shen

Xi Wang

Yi-Ying Xiao

Jia-Ying Zhang

Guo-Lian Xia

Rong-Lin Jiang

Affiliations

Soon will be listed here.

Abstract

Background: The prognosis of critically ill patients is closely linked to their gastrointestinal (GI) function. The acute GI injury (AGI) grading system, established in 2012, is extensively utilized to evaluate GI dysfunction and forecast outcomes in clinical settings. In 2021, the GI dysfunction score (GIDS) was developed, building on the AGI grading system, to enhance the accuracy of GI dysfunction severity assessment, improve prognostic predictions, reduce subjectivity, and increase reproducibility.

Aim: To compare the predictive capabilities of GIDS and the AGI grading system for 28-day mortality in critically ill patients.

Methods: A retrospective study was conducted at the general intensive care unit (ICU) of a regional university hospital. All data were collected during the first week of ICU admission. The primary outcome was 28-day mortality. Multivariable logistic regression analyzed whether GIDS and AGI grade were independent risk factors for 28-day mortality. The predictive abilities of GIDS and AGI grade were compared using the receiver operating characteristic curve, with DeLong's test assessing differences between the curves' areas.

Results: The incidence of AGI in the first week of ICU admission was 92.13%. There were 85 deaths (47.75%) within 28 days of ICU admission. There was no initial 24-hour difference in GIDS between the non-survival and survival groups. Both GIDS (OR 2.01, 95%CI: 1.25-3.24; = 0.004) and AGI grade (OR 1.94, 95%CI: 1.12-3.38; = 0.019) were independent predictors of 28-day mortality. No significant difference was found between the predictive accuracy of GIDS and AGI grade for 28-day mortality during the first week of ICU admission (Z = -0.26, = 0.794).

Conclusion: GIDS within the first 24 hours was an unreliable predictor of 28-day mortality. The predictive accuracy for 28-day mortality from both systems during the first week was comparable.

Citing Articles

Improving gastrointestinal scoring systems for predicting short-term mortality in critically ill patients.

Moore S, Donlon N World J Gastroenterol. 2025; 31(5):102622.

PMID: 39926223 PMC: 11718617. DOI: 10.3748/wjg.v31.i5.102622.

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