Gastrointestinal failure score in children with traumatic brain injury

Ying Zhou,Weibing Tang,Weifeng Lu

doi:10.1186/s12887-021-02673-5

Ying Zhou, Weibing Tang + Show 1 more

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https://doi.org/10.1186/s12887-021-02673-5

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Abstract

BackgroundTo 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.MethodsA 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), 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.ResultsThe percentage 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 were significantly different between children with different degrees of TBI (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.ConclusionsThe 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.

Highlights

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
The clinical parameters that were collected on admission included sex, age, body mass index (BMI), Glasgow Coma Scale (GCS) score, leukocyte count, C-reactive protein (CRP) level, hemoglobin (Hb), hematocrit (Hct), blood glucose (Glu), lactic acid (Lac), procalcitonin (PCT), albumin (ALB), plasma osmotic pressure (POP), prothrombin time (PT) and activated partial thromboplastin time (APTT)
The children were divided into two groups based on whether Food intolerance (FI) occurred on the first day of admission

Summary

Introduction

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. The incidence of TBI in European and American countries is as high as 150–200/100,000/ year, while the incidence is approximately 100–150/100, 000/year in China [1, 2] Due to their young age, low crisis awareness and poor self-protection ability, severe TBIs resulting in a Glasgow Coma Scale (GCS) score of less than 8 are very common in children. Children with such TBIs have a mortality rate of 20 % and a severe disability rate of > 50 % [3] and require monitoring and treatment in intensive care units (ICUs).

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