Gastrointestinal symptoms in intensive care patients
Gastrointestinal symptoms in intensive care patients
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DOI：
10.1111/j.1399-6576.2008.01860.x
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发表时间：
2009-03-01
影响因子：
2.1
通讯作者：
Starkopf, J.
中科院分区：
文献类型：
--
作者：
Reintam, A.;Parm, P.;Starkopf, J.
在重症监护室（ICU）患者中，胃肠道（GI）问题的评估不一致，现有文献中的相应数据不足。本研究对2004- 2007年塔尔图大学医院综合ICU住院的所有患者进行前瞻性研究，目的是描述不同GI症状的患病率、危险因素和重要性。775例（59.1%）患者在住院1天内至少有一种GI症状，而475例（36.2%）患者有一种以上症状。在ICU住院期间，542例患者（41.3%）记录到肠鸣音缺失或异常，501例（38.2%）记录到呕吐/反流，298例（22.7%）记录到胃吸出物量高，184例（14.0%）记录到腹泻，139例（10.6%）记录到肠扩张，97例（7.4%）记录到GI出血。肠鸣音缺失或异常和胃肠道出血与死亡率显著升高相关。同时出现胃肠道症状的数量是ICU死亡率的独立危险因素。同时出现两种或两种以上胃肠道症状的患者的ICU住院时间和死亡率显著高于最多出现一种胃肠道症状的患者。肠鸣音缺失和胃肠道出血与预后受损相关。在ICU第一天的GI症状的患病率预测患者的死亡率。
Gastrointestinal (GI) problems are not uniformly assessed in intensive care unit (ICU) patients and respective data in available literature are insufficient. We aimed to describe the prevalence, risk factors and importance of different GI symptoms.We prospectively studied all patients hospitalized to the General ICU of Tartu University Hospital in 2004-2007.Of 1374 patients, 62 were excluded due to missing data. Seven hundred and seventy-five (59.1%) patients had at least one GI symptom at least during 1 day of their stay, while 475 (36.2%) suffered from more than one symptom. Absent or abnormal bowel sounds were documented in 542 patients (41.3%), vomiting/regurgitation in 501 (38.2%), high gastric aspirate volume in 298 (22.7%), diarrhoea in 184 (14.0%), bowel distension in 139 (10.6%) and GI bleeding in 97 (7.4%) patients during their ICU stay. Absent or abnormal bowel sounds and GI bleeding were associated with significantly higher mortality. The number of simultaneous GI symptoms was an independent risk factor for ICU mortality. The ICU length of stay and mortality of patients who had two or more GI symptoms simultaneously were significantly higher than in patients with a maximum of one GI symptom.GI symptoms occur frequently in ICU patients. Absence of bowel sounds and GI bleeding are associated with impaired outcome. Prevalence of GI symptoms at the first day in ICU predicts the mortality of the patients.