The classification, prognosis and causes of acute gastrointestinal injury in PICU children

Abstract

Objective To investigate the classification, prognosis and causes of acute gastrointestinal injury(AGI) in PICU patients in our hospital. Methods Patients were included if they had been hospitalized in PICU at least 24 h before the AGI diagnosis from January 2015 to April 2018.Patients were classified according to severity of gastrointestinal dysfunction.Clinical characteristics, pediatric critical illness scores, pediatric logistic organ dysfunction score 2 and 28-day mortality, as well as mechanical ventilation were recorded. Results A total of 220 patients were enrolled.AGIⅠ-Ⅳ groups included 66(30.0%), 97(44.1%), 37(16.8%)and 20(9.1%) patients, respectively, while primary AGI and secondary AGI included 149(67.7%) and 71 (32.3%)patients, respectively.There was no significant difference among four groups in gender, hospitalization time in PICU and total hospitalization time (P>0.05), but there were significant differences in median age, pediatric critical illness scores, pediatric logistic organ dysfunction score 2 and proportion of mechanical ventilation(P<0.05). Median age(month) was 3 (1, 15), 11 (2, 24), 11 (2, 36), and 4 (0.5, 11.5), respectively in AGI Ⅰ-Ⅳ groups.The total 28-day mortality rate of AGI Ⅰ-Ⅳ groups accounted for 0, 0, 13.2% and 3.2%, respectively. Conclusion Patients in PICU are prone to AGI.AGIⅠand AGI Ⅱare common.The prognosis is associated with classification of AGI.The higher grades of AGI are, the worse prognosis is.The prognosis of AGI Ⅲ is the worst, because of different causes. Key words: Children; Acute gastrointestinal injury; Prognosis; Pediatric critical illness score