Comparing gastrointestinal dysfunction score and acute gastrointestinal injury grade for predicting short-term mortality in critically ill patients

Table 1 Characteristics of the patients according to 28-day mortality

Characteristics	All (n = 178)	Survivors (n = 93)	Non-survivors (n = 85)	Statistic	P value
Age, years	76.00 (67.00, 83.00)	75.00 (63.00, 83.00)	77.00 (68.00, 83.00)	Z = -1.23	0.218
Male, n (%)	108 (60.67)	55 (59.14)	53 (62.35)	χ² = 0.19	0.661
Pre-existing diseases
Diabetes mellitus, n (%)	56 (31.46)	30 (32.26)	26 (30.59)	χ² = 0.06	0.811
Hyptertension, n (%)	95 (53.37)	46 (49.46)	49 (57.65)	χ² = 1.20	0.274
Coronary heart disease, n (%)	40 (22.47)	17 (18.28)	23 (27.06)	χ² = 1.96	0.161
Stroke, n (%)	25 (14.04)	16 (17.20)	9 (10.59)	χ² = 1.61	0.204
Principal pathology
Cardiovascular, n (%)	16 (8.99)	7 (7.53)	9 (10.59)	χ² = 0.51	0.476
Neurological, n (%)	16 (8.99)	10 (10.75)	6 (7.06)	χ² = 0.74	0.389
GI/pancreatic/liver, n (%)	23 (12.92)	14 (15.05)	9 (10.59)	χ² = 0.79	0.375
Pulmonary, n (%)	76 (42.70)	35 (37.63)	41 (48.24)	χ² = 2.04	0.153
Renal, n (%)	13 (7.30)	8 (8.60)	5 (5.88)	χ² = 0.49	0.486
Metabolic disorders, n (%)	6 (3.37)	3 (3.23)	3 (3.53)	χ² = 0.00	> 0.999
Heart rate1, beats/minute	98.47 ± 21.55	97.96 ± 21.65	99.02 ± 21.55	t= -0.33	0.743
C-reactive protein1, mg/L	64.63 (23.67, 138.11)	54.43 (18.23, 144.60)	82.74 (40.36, 132.42)	Z = -1.19	0.235
Glucose1, mmol/L	9.31 (7.08, 13.00)	8.97 (7.11, 12.10)	9.42 (7.00, 14.65)	Z = -0.48	0.629
Albumin1, g/L	28.20 (25.10, 32.03)	28.90 (25.80, 32.90)	27.20 (24.50, 29.30)	Z = -2.73	0.006
Serum lactate1, mmol/L	1.70 (1.20, 2.98)	1.60 (0.90, 2.40)	1.90 (1.30, 3.30)	Z = -2.36	0.018
Procalcitonin1, ng/mL	0.68 (0.20, 2.81)	0.58 (0.18, 3.35)	0.78 (0.29, 2.45)	Z = -0.89	0.373
Sepsis, n (%)	43 (24.16)	21 (22.58)	22 (25.88)	χ² = 0.26	0.607
Abdominal surgery, n (%)	25 (14.04)	16 (17.20)	9 (10.59)	χ² = 1.61	0.204
Acute kidney injure, n (%)	93 (52.25)	39 (41.94)	54 (63.53)	χ² = 8.30	0.004
Mechanical ventilation, n (%)	145 (81.46)	63 (67.74)	82 (96.47)	χ² = 24.27	< 0.001
Start EN within 48 hours, n (%)	138 (77.53)	73 (78.49)	65 (76.47)	χ² = 0.10	0.747
SOFA score2, points	7.00 (5.00, 11.00)	6.00 (4.00, 9.00)	9.00 (6.00, 11.00)	Z = -4.45	< 0.001
SOFA score3, points	11.00 (7.00, 15.00)	8.00 (6.00, 11.00)	14.00 (11.00, 16.00)	Z = -8.28	< 0.001
APACHE II score2, points	19.00 (15.00, 24.00)	18.00 (13.00, 22.00)	21.00 (16.00, 25.00)	Z = -2.38	0.017
APACHE II score3, points	22.00 (17.00, 28.00)	18.00 (14.00, 22.00)	26.00 (23.00, 32.00)	Z = -7.20	< 0.001
AGI grade3, grade	2.00 (2.00, 3.00)	2.00 (1.00, 2.00)	3.00 (2.00, 3.00)	Z = -6.85	< 0.001
GIDS2, points	1.00 (0.00, 1.00)	1.00 (0.00, 1.00)	1.00 (0.00, 1.00)	Z = -1.15	0.249
GIDS3, points	2.00 (1.00, 2.00)	1.00 (1.00, 2.00)	2.00 (2.00, 3.00)	Z = -6.90	< 0.001

¹Assessed within the first 24 hours of intensive care unit admission.

²Maximum values during the first 24 hours of intensive care unit admission.

³Maximum values during the first week of intensive care unit admission.

t: t-test; Z: Mann-Whitney test; χ²: Chi-square test. GI: Gastrointestinal; EN: Enteral nutrition; SOFA: Sequential organ failure assessment; APACHE II: Acute Physiology and Chronic Health Evaluation II; AGI: Acute gastrointestinal injury; GIDS: Gastrointestinal dysfunction score.

Table 2 Multivariate logistic regression analysis with 28-day mortality

Variables	Model 1		Model 2
	P value	OR (95%CI)	P value	OR (95%CI)
Pre-existing disease-coronary heart disease	0.152	2.12 (0.76-5.92)	0.185	1.99 (0.72-5.53)
Principal pathology- Pulmonary	0.119	2.05 (0.83-5.05)	0.139	1.96 (0.80-4.76)
Albumin	0.609	0.98 (0.91-1.05)	0.733	0.99 (0.92-1.06)
Serum lactate	0.316	0.91 (0.77-1.09)	0.283	0.91 (0.76-1.08)
Mechanical ventilation	0.129	3.16 (0.72-13.95)	0.107	3.37 (0.77-14.77)
SOFA score1	< 0.001	1.32 (1.13-1.54)	0.001	1.29 (1.11-1.52)
APACHE II score1	0.070	1.08 (0.99-1.18)	0.058	1.09 (1.00-1.18)
GIDS1	0.004	2.01 (1.25-3.24)	/	/
AGI grade1	/	/	0.019	1.94 (1.12-3.38)

¹Maximum values during the first week of intensive care unit admission.

SOFA: Sequential organ failure assessment; APACHE II: Acute Physiology and Chronic Health Evaluation II; AGI: Acute gastrointestinal injury; GIDS: Gastrointestinal dysfunction score.

Table 3 Analysis of the receiver operating characteristic curve values of scoring systems in predicting 28-day mortality in critically ill patients

Scoring system	AUC	P value	95%CI	Cut-off value	Sensitivity (%)	Specificity (%)	YI	PV+ (%)	PV- (%)
GIDS1	0.785	< 0.001	0.720-0.851	1.5	87.06	67.74	0.548	71.15	85.14
AGI1	0.779	< 0.001	0.713-0.845	2.5	69.41	84.95	0.544	80.82	75.24
SOFA1	0.859	< 0.001	0.805-0.913	9.5	87.06	67.74	0.548	71.15	85.14
APACHE II1	0.812	< 0.001	0.749-0.875	21.5	81.18	70.97	0.521	71.88	80.49
SOFA + GIDS2	0.874	< 0.001	0.822-0.927	11.5	88.24	74.19	0.624	75.76	87.34
SOFA + AGI2	0.869	< 0.001	0.816-0.921	12.5	85.88	75.27	0.612	76.04	85.37
APACHE II + GIDS2	0.833	< 0.001	0.774-0.892	23.5	81.18	74.19	0.554	74.19	81.18
APACHE II + AGI2	0.831	< 0.001	0.771-0.890	23.5	84.71	69.89	0.546	72.00	83.33

¹Maximum values during the first week of intensive care unit (ICU) admission.

²Maximum combination values during the first week of ICU admission.

AUC: Area under the receiver operating characteristic curve; YI: Youden index; PV+: Positive predictive value; PV-: Negative predictive value; SOFA: Sequential organ failure assessment; APACHE II: Acute Physiology and Chronic Health Evaluation II; AGI: Acute gastrointestinal injury; GIDS: Gastrointestinal dysfunction score.