Risk Factors And Prognosis Of Acute Gastrointestinal Injury In Patients With Respiratory Failure Caused By Non-Abdominal Diseases

Objective:To investigate the clinical features,risk factors and prognosis of patients with non-abdominal respiratory failure(RF)complicated with acute gastrointestinal injury(AGI),and to implement early intervention therapy through the prediction of RF risk of AGI morbidity and mortality.Reduce its mortality.Methods:A retrospective study was conducted to analyze patients with RF diagnosis admitted to the ICU of Wuxi Second Hospital affiliated to Nanjing Medical University from April 2016 to July 2018.According to whether or not AGI is concurrent,it is divided into AGI+and AGI-group.The AGI+component was further divided into a survival group and a death group.The general data,routine laboratory findings,disease assessment indicators,and prognosis between the AGI+group and the AGI-group and the AGI+group were compared,and then statistically significant multivariate regression analysis was performed.To explore RF complicated with AGI and prognostic risk factors.Result:(1)A total of 214 RF patients were enrolled,including 156 males(72.9%)and 58 females(27.1%).There were 100 cases with AGI(46.7%)and 114 cases without AGI(53.3%).Among them,44 cases died in AGI+group,the mortality rate was 44%,18 cases died in AGI-group,the mortality rate was 15.8%.The difference was statistically significant(P<0.05).The incidence of AGI Ⅰ,Ⅱ,Ⅲ and Ⅳ was 66%,25%,9%and 0%,respectively.There were no AGI IV patients,and the mortality corresponding to AGI grade was 33.8%,57.7%and 77.8%respectively.The mortality increased with the increase of AGI grade in patients with ARF complicated with AGI.(2)Compared with AGI-group,MAP,PaO2,PaO2/FiO2 in AGI+group were lower than those in AGI’ group,while the percentage of catecholamines,hormones,APACHE-I1 score,SOFA score,WBC,Lac,CK and CK-MB in AGI-group were higher than those in AGI-group(P<0.05).Logistic regression analysis showed that partial oxygen pressure<60 mmHg(OR=2.090,95%CI:1.065～4.104,P=0.032)and catecholamine use(OR=2.489,95%CI:1.383～4.483,P=0.025)were risk factors for AGI in RF patients.(3)Compared with the survival group,the proportion of males,catecholamine use,Proportion of mechanical ventilation,Mechanical ventilation time,Lac,WBC,APACHE-II score and the number of organ failure in the death group were higher than those in the survival group(P<0.05).Multivariate regression analysis showed that MAP<70 mmHg(OR=1.139,95%CI:1.121～1.159,P=0.001)and the number of organ failure(OR=1.583,95%CI:1.117-2.243,P～0.010)were risk factors for death in patients with RF complicated with AGI.Conclusion:Partial oxygen pressure<60 mmHg and catecholamine use are risk factors for AGI in RF patients.mean arterial pressure<70 mmHg and the number of organ failure are risk factors for death in RF patients with AGI,which can provide reference for early prediction of AGI and early intervention.