PDF(Pubmed)
Abstract：
BACKGROUND: The I-FEED classification, scored 0-8, was reported to accurately describe the clinical manifestations of gastrointestinal impairment after colorectal surgery. Therefore, it is interesting to determine whether the I-FEED scoring system is also applicable to patients undergoing lumbar spine surgery.
METHODS: Adult patients undergoing elective lumbar spine surgery were enrolled, and the I-FEED score was measured for 4 days after surgery. The I-FEED scoring system incorporates five elements: intake (score: 0, 1, 3), feeling nauseated (score: 0, 1, 3), emesis (score: 0, 1, 3), results of physical exam (score: 0, 1, 3), and duration of symptoms (score: 0, 1, 2). Daily I-FEED scores were summed, and the highest overall score is used to categorize patients into one of three categories: normal (0-2 points), postoperative gastrointestinal intolerance (POGI; 3-5 points), and postoperative gastrointestinal dysfunction (POGD; 6 + points). The construct validity hypothesis testing determines whether the I-FEED category is consistent with objective clinical findings relevant to gastrointestinal impairment, namely, the longer length of hospital stay (LOS), higher inhospital medical cost, more postoperative gastrointestinal medical treatment, and more postoperative non-gastrointestinal complications.
RESULTS: A total of 156 patients were enrolled, and 25.0% of patients were categorized as normal, 49.4% POGI, and 25.6% POGD. Patients with higher I-FEED scores agreed with the four validity hypotheses. Patients with POGD had a significantly longer length of hospital stay (1 day longer median stay; p = 0.049) and more inhospital medical costs (approximately 500 Taiwanese dollars; p = 0.037), and more patients with POGD required rectal laxatives (10.3% vs. 32.5% vs. 32.5%; p = 0.026). In addition, more patients with POGD had non-gastrointestinal complications (5.1% vs. 11.7% vs. 30.0%; p = 0.034).
CONCLUSIONS: This study contributes preliminary validity evidence for the I-FEED score as a measure for postoperative gastrointestinal impairment after elective lumbar spine surgery.
METHODS: Adult patients undergoing elective lumbar spine surgery were enrolled, and the I-FEED score was measured for 4 days after surgery. The I-FEED scoring system incorporates five elements: intake (score: 0, 1, 3), feeling nauseated (score: 0, 1, 3), emesis (score: 0, 1, 3), results of physical exam (score: 0, 1, 3), and duration of symptoms (score: 0, 1, 2). Daily I-FEED scores were summed, and the highest overall score is used to categorize patients into one of three categories: normal (0-2 points), postoperative gastrointestinal intolerance (POGI; 3-5 points), and postoperative gastrointestinal dysfunction (POGD; 6 + points). The construct validity hypothesis testing determines whether the I-FEED category is consistent with objective clinical findings relevant to gastrointestinal impairment, namely, the longer length of hospital stay (LOS), higher inhospital medical cost, more postoperative gastrointestinal medical treatment, and more postoperative non-gastrointestinal complications.
RESULTS: A total of 156 patients were enrolled, and 25.0% of patients were categorized as normal, 49.4% POGI, and 25.6% POGD. Patients with higher I-FEED scores agreed with the four validity hypotheses. Patients with POGD had a significantly longer length of hospital stay (1 day longer median stay; p = 0.049) and more inhospital medical costs (approximately 500 Taiwanese dollars; p = 0.037), and more patients with POGD required rectal laxatives (10.3% vs. 32.5% vs. 32.5%; p = 0.026). In addition, more patients with POGD had non-gastrointestinal complications (5.1% vs. 11.7% vs. 30.0%; p = 0.034).
CONCLUSIONS: This study contributes preliminary validity evidence for the I-FEED score as a measure for postoperative gastrointestinal impairment after elective lumbar spine surgery.
摘要：
背景：I-FEED分类，得分为0-8分，据报道可以准确描述结直肠手术后胃肠道损害的临床表现。因此,确定I-FEED评分系统是否也适用于接受腰椎手术的患者很有趣.
方法：纳入择期腰椎手术的成年患者，术后4天测量I-FEED评分。I-FEED评分系统包含五个要素：摄入量（得分：0，1，3），感到恶心（得分：0，1，3），呕吐（得分：0，1，3），体检结果（分数：0，1，3），和症状持续时间（评分：0，1，2）。总结了每日I-FEED分数，最高的总分用于将患者分为三类：正常（0-2分），术后胃肠不耐受（POGI；3-5分），术后胃肠功能障碍(POGD;6+分)。结构效度假设检验确定I-FEED类别是否与胃肠道损害相关的客观临床发现一致，即,住院时间越长（LOS），医院医疗费用较高，更多的术后胃肠药物治疗，术后非胃肠道并发症较多。
结果：共纳入156例患者，25.0%的患者被归类为正常，49.4%POGI，和25.6%的POGD。I-FEED评分较高的患者同意四个有效性假设。POGD患者的住院时间明显更长（中位住院时间延长1天；p=0.049），住院医疗费用更高（约500新台币；p=0.037），更多的POGD患者需要直肠泻药(10.3%vs.32.5%vs.32.5%；p=0.026）。此外,更多的POGD患者有非胃肠道并发症(5.1%vs.11.7%与30.0%；p=0.034）。
结论：本研究为I-FEED评分作为选择性腰椎手术后胃肠道损伤的指标提供了初步的有效性证据。
方法：纳入择期腰椎手术的成年患者，术后4天测量I-FEED评分。I-FEED评分系统包含五个要素：摄入量（得分：0，1，3），感到恶心（得分：0，1，3），呕吐（得分：0，1，3），体检结果（分数：0，1，3），和症状持续时间（评分：0，1，2）。总结了每日I-FEED分数，最高的总分用于将患者分为三类：正常（0-2分），术后胃肠不耐受（POGI；3-5分），术后胃肠功能障碍(POGD;6+分)。结构效度假设检验确定I-FEED类别是否与胃肠道损害相关的客观临床发现一致，即,住院时间越长（LOS），医院医疗费用较高，更多的术后胃肠药物治疗，术后非胃肠道并发症较多。
结果：共纳入156例患者，25.0%的患者被归类为正常，49.4%POGI，和25.6%的POGD。I-FEED评分较高的患者同意四个有效性假设。POGD患者的住院时间明显更长（中位住院时间延长1天；p=0.049），住院医疗费用更高（约500新台币；p=0.037），更多的POGD患者需要直肠泻药(10.3%vs.32.5%vs.32.5%；p=0.026）。此外,更多的POGD患者有非胃肠道并发症(5.1%vs.11.7%与30.0%；p=0.034）。
结论：本研究为I-FEED评分作为选择性腰椎手术后胃肠道损伤的指标提供了初步的有效性证据。
