Association between Gastrointestinal Dysfunction Score (GIDS) and disease severity and prognosis in critically ill patients: A prospective, observational study

Xinyan Liu; Qizhi Wang; Daqiang Yang; Maoliang Fu; Maopeng Yang; Yang Bi; Chunting Wang; Xuan Song

doi:10.1016/j.clnu.2023.03.004

Association between Gastrointestinal Dysfunction Score (GIDS) and disease severity and prognosis in critically ill patients: A prospective, observational study

Clin Nutr. 2023 May;42(5):700-705. doi: 10.1016/j.clnu.2023.03.004. Epub 2023 Mar 7.

Authors

Xinyan Liu¹, Qizhi Wang², Daqiang Yang¹, Maoliang Fu¹, Maopeng Yang¹, Yang Bi³, Chunting Wang², Xuan Song⁴

Affiliations

¹ ICU, Dong E Hospital, Liaocheng, Shandong, China.
² ICU, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China.
³ Intensive Care Medicine, Shandong First Medical University, Jinan, Shandong, China.
⁴ ICU, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China; Shandong Institute of Endocrine & Metabolic Diseases Affiliated to Shandong First Medical University, Jinan, Shandong, China. Electronic address: songxuan0303@163.com.

PMID: 36958226
DOI: 10.1016/j.clnu.2023.03.004

Abstract

Objectives: Recently, the Gastrointestinal Dysfunction Score (GIDS) was developed for use with critically ill patients. This study evaluated the association of GIDS with disease severity and clinical outcomes to assess the technical feasibility of using GIDS to reflect the severity and short-term prognosis of critically ill patients.

Methods: Association between Gastrointestinal Dysfunction Score (GIDS) and disease severity and prognosis in critically ill patients: A prospective, observational study. This was a prospective observational study involving adult patients in two Intensive Care Units (ICUs). During the first seven days of ICU admission, GIDS, acute gastrointestinal injury (AGI), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA) scores were assessed daily.

Results: A total of 276 patients from two centers were enrolled in this study. Patients were divided into GIDS 0-1 (121, 43.8%) and GIDS 2-4 (155, 56.2%). The ICU length of stay and 28-day mortality in the GIDS 2-4 group were significantly higher than the GIDS 0-1 group (P = 0.032, P = 0.001, respectively). The APACHE II and SOFA scores in the GIDS 2-4 group were also significantly higher (P < 0.001). The ROC curves of GIDS, AGI, APACHE II, and SOFA scores on the first day of ICU admission for the prediction of 28-day mortality showed that the AUC of GIDS was 0.702 (95%CI 0.628, 0.775; P < 0.001). The AUC for GIDS + SOFA was 0.719 (95%CI 0.648, 0.790; P < 0.001), compared with SOFA alone (AUC = 0.703), showing improved predictive power for 28-day mortality.

Conclusions: GIDS represents a step toward a reliable clinical tool for GI dysfunction to assess disease severity and short-term prognosis in critically ill patients. In addition, combining GIDS with SOFA score may better predict mortality risk compared to SOFA score alone.

Keywords: Critical care; Gastrointestinal dysfunction; Mortality; Outcome; Severity.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

APACHE
Adult
Critical Illness*
Humans
Intensive Care Units
Organ Dysfunction Scores*
Prognosis
Prospective Studies
ROC Curve
Retrospective Studies