Giá trị tiên lượng của điểm suy dạ dày – ruột ở bệnh nhân viêm tụy cấp được điều trị tại Trung tâm Hồi sức tích cực, Bệnh viện Bạch Mai

Acute pancreatitis (AP) is a severe inflammatory condition often associated with significant morbidity and mortality, particularly in its severe forms where multi-organ dysfunction is common. Among the various organ systems affected, gastrointestinal failure (GIF) is increasingly recognized as a crucial component influencing patient outcomes, yet its prognostic value is not always comprehensively assessed by traditional scoring systems. Understanding the role of specific tools, such as the Gastrointestinal Failure (GIF) score, in predicting patient trajectories is vital for optimizing clinical management in the intensive care unit (ICU). This study aims to evaluate the prognostic utility of the GIF score in critically ill patients with severe acute pancreatitis, specifically focusing on its ability to predict recovery time and mortality.

Critical care physicians, gastroenterologists, intensivists, medical researchers, and students interested in the management and prognostication of acute pancreatitis and gastrointestinal dysfunction.

This observational study investigated the prognostic value of the 3-day mean Gastrointestinal Failure (GIF) score in 96 critically ill patients predominantly suffering from severe acute pancreatitis (87.5%) admitted to the Intensive Care Unit (ICU) at Bach Mai Hospital. Researchers assessed the GIF score daily for the first three days and monitored outcomes including 28-day mortality and ICU length of stay. Statistical analyses, including logistic and Cox regression, adjusted for baseline factors, were employed to determine prognostic associations.The study revealed that a higher mean 3-day GIF score was a statistically significant predictor of prolonged ICU recovery time (Hazard Ratio = 0.49, 95% CI: 0.36-0.66, p < 0.001), indicating that patients with greater gastrointestinal dysfunction tend to require longer intensive care. For mortality prognosis, the mean 3-day GIF score showed an association in univariate analysis (OR = 4.62, p = 0.041) with acceptable discriminatory ability (AUC = 0.735, p = 0.039). However, its independent predictive power for mortality diminished in a multivariable model adjusted for factors like the Marshall score and age (p = 0.143), suggesting that the GIF score's impact on mortality might be masked by or less potent than systemic multi-organ failure.These findings underscore the GIF score's valuable role in predicting ICU recovery time in acute pancreatitis patients, highlighting its utility for early identification of patients at risk for prolonged stays. While its stand-alone prognostic capability for mortality is less robust compared to comprehensive multi-organ failure scores like SOFA and Marshall, which demonstrated superior predictive abilities (AUC > GIF), the GIF score provides specific insights into gastrointestinal dysfunction. Therefore, integrating GIF score monitoring with broader multi-organ assessment tools is recommended for a more comprehensive and proactive prognostic evaluation in severe acute pancreatitis, guiding more precise and timely therapeutic interventions.