Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Abstract

PurposesTo 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 2019 were retrospectively analyzed. Admission parameters were sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). In order to predict outcome, Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS) and mean GIF score for the first three days were also combined.ResultsThe percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) developed in 36.4% and intra-abdominal hypertension (IAH) in 21.8% of patients. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); they were also significantly different between those 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.ConclusionThe incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has its ability to judge gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.