Your browser doesn't support javascript.
Acute Gastrointestinal Injury and Feeding Intolerance as Prognostic Factors in Critically Ill COVID-19 Patients.
Drakos, Panagiotis; Volteas, Panagiotis; Cleri, Nathaniel A; Alkadaa, Leor N; Asencio, Anthony A; Oganov, Anthony; Pryor, Aurora; Talamini, Mark; Rubano, Jerry; Bannazadeh, Mohsen; Mikell, Charles B; Spaniolas, Konstantinos; Mofakham, Sima.
  • Drakos P; Department of Surgery, Renaissance School of Medicine, HSC T-12, Room 064, Stony Brook, NY, 11794, USA.
  • Volteas P; Department of Surgery, Renaissance School of Medicine, HSC T-12, Room 064, Stony Brook, NY, 11794, USA.
  • Cleri NA; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Alkadaa LN; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Asencio AA; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Oganov A; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Pryor A; Department of Surgery, Renaissance School of Medicine, HSC T-12, Room 064, Stony Brook, NY, 11794, USA.
  • Talamini M; Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Rubano J; Department of Surgery, Renaissance School of Medicine, HSC T-12, Room 064, Stony Brook, NY, 11794, USA.
  • Bannazadeh M; Department of Surgery, Renaissance School of Medicine, HSC T-12, Room 064, Stony Brook, NY, 11794, USA.
  • Mikell CB; Department of Surgery, Renaissance School of Medicine, HSC T-12, Room 064, Stony Brook, NY, 11794, USA.
  • Spaniolas K; Division of Vascular Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA.
  • Mofakham S; Department of Neurosurgery, Renaissance School of Medicine, Stony Brook, NY, USA.
J Gastrointest Surg ; 26(1): 181-190, 2022 01.
Article in English | MEDLINE | ID: covidwho-1202825
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Feeding intolerance PROCESS_OF Patients
Subject
Feeding intolerance
Predicate
PROCESS_OF
Object
Patients
3. Intubated PROCESS_OF Patients
Subject
Intubated
Predicate
PROCESS_OF
Object
Patients
4. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
5. Feeding intolerance PROCESS_OF Patients
Subject
Feeding intolerance
Predicate
PROCESS_OF
Object
Patients
6. Intubated PROCESS_OF Patients
Subject
Intubated
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

Although acute gastrointestinal injury (AGI) and feeding intolerance (FI) are known independent determinants of worse outcomes and high mortality in intensive care unit (ICU) patients, the incidence of AGI and FI in critically ill COVID-19 patients and their prognostic importance have not been thoroughly studied.

METHODS:

We reviewed 218 intubated patients at Stony Brook University Hospital and stratified them into three groups based on AGI severity, according to data collected in the first 10 days of ICU course. We used chi-square test to compare categorical variables such as age and sex and two-sample t-test or Mann-Whitney U-tests for continuous variables, including important laboratory values. Cox proportional hazards regression models were utilized to determine whether AGI score was an independent predictor of survival, and multivariable analysis was performed to compare risk factors that were deemed significant in the univariable analysis. We performed Kaplan-Meier survival analysis based on the AGI score and the presence of FI.

RESULTS:

The overall incidence of AGI was 95% (45% AGI I/II, 50% AGI III/IV), and FI incidence was 63%. Patients with AGI III/IV were more likely to have prolonged mechanical ventilation (22 days vs 16 days, P-value <0.002) and higher mortality rate (58% vs 28%, P-value <0.001) compared to patients with AGI 0/I/II. This was confirmed with multivariable analysis which showed that AGI score III/IV was an independent predictor of higher mortality (AGI III/IV vs AGI 0/I/II hazard ratio (HR), 2.68; 95% confidence interval (CI), 1.69-4.25; P-value <0.0001). Kaplan-Meier survival analysis showed that both AGI III/IV and FI (P-value <0.001) were associated with worse outcomes. Patients with AGI III/IV had higher daily and mean D-dimer and CRP levels compared to AGI 0/I/II (P-value <0.0001).

CONCLUSIONS:

The prevalence of AGI and FI among critically ill COVID-19 patients was high. AGI grades III/IV were associated with higher risk for prolonged mechanical ventilation and mortality compared to AGI 0/I/II, while it also correlated with higher D-dimer and C-reactive protein (CRP) levels. FI was independently associated with higher mortality. The development of high-grade AGI and FI during the first days of ICU stay can serve as prognostic tools to predict outcomes in critically ill COVID-19 patients.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrointestinal Diseases / COVID-19 Type of study: Prognostic study / Randomized controlled trials / Risk factors Limits: Humans / Infant, Newborn Language: English Journal: J Gastrointest Surg Journal subject: Gastroenterology Year: 2022 Document Type: Article Affiliation country: S11605-021-05015-z

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrointestinal Diseases / COVID-19 Type of study: Prognostic study / Randomized controlled trials / Risk factors Limits: Humans / Infant, Newborn Language: English Journal: J Gastrointest Surg Journal subject: Gastroenterology Year: 2022 Document Type: Article Affiliation country: S11605-021-05015-z