Validation of the GastroIntestinal Dysfunction Score (GIDS): prospective observational multicentre study (GUTPHOS Study)

The present multicentre, prospective cohort study of intensive care unit (ICU) patients aims to validate the recently developed Gastrointestinal Dysfunction Score (GIDS) against mortality, given the absence of gold standard for respective organ dysfunction assessment. Consecutive adult patients admitted to ICUs worldwide were included from 28 ICUs worldwide between January and August 2024, with a maximum of 120 patients per site during an eight-week study period. Patients were monitored daily from ICU admission to discharge or a maximum of seven days in the ICU. Cox proportional hazards models with time-dependent covariates were used for 28- and 90-day mortality, and C-statistics to evaluate relative contribution of GIDS added to SOFA total and SOFA subscores. Binary and ordinal logistic regression were used for parenteral nutrition (PN) and ICU dependency, respectively. In total, 2679 patients from 28 sites were included. The GIDS was associated with 28- and 90-day mortality when adjusted for total SOFA score or all SOFA subscores in the full cohort analysis ( n = 2629). In the small cohort where all the variables of the GIDS were available (both intra-abdominal pressure and gastric residual volumes measured, n = 311), it associated with 28-day, but not with 90-day mortality. Adding GIDS to SOFA score slightly improved the predictive value of the latter for 28- and 90-day mortality in the full cohort analysis (C-statistic from 0.826 to 0.835 and 0.765 to 0.773, respectively). Increasing GIDS was associated with greater PN use and fewer ICU-free days. The GIDS was successfully validated against mortality and is proposed for assessment of GI dysfunction as a part of multiple organ dysfunction. The study was registered on ClinicalTrials.gov (NCT05909722) on 18.06.2023.

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Journal
Critical Care
Published
2026-09-30
DOI
https://doi.org/10.1186/s13054-026-06337-7
Primary Topic
Clinical Nutrition and Gastroenterology
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article
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article

Validation of the GastroIntestinal Dysfunction Score (GIDS): prospective observational multicentre study (GUTPHOS Study)

Anca Balintescu, Bastian Pasieka, Olivier Pantet, Guillaume Besch et al.
Critical Care
Clinical Nutrition and Gastroenterology
article

Validation of the GastroIntestinal Dysfunction Score (GIDS): prospective observational multicentre study (GUTPHOS Study)

Anca Balintescu, Bastian Pasieka, Olivier Pantet, Guillaume Besch, Merli Mändul, Giuliano Bolondi, Stefan Josef Schaller, Μαρία Θεοδωρακοπούλου, Cecilia Loudet, K. Muhhamedjanov, Sirak Petros, Yaseen M. Arabi, Antonella Cotoia, Ramprasad Matsa, Varsha M. Asrani, Lies Langouche, Hans-Erik Ehrlich, Oskar Appelberg, Jan Gunst, Martin Sundström Rehal, Kristina Kilsand, Laura Borgstedt, Natalija Vuković, Arthur R. H. van Zanten, Lulu Sheng, Kristina E. Fuest, Zhigang Chang, Veronika Řehořová, Michael Paul Casaer, František Duška, Juan Carlos Lopez‐Delgado, Imre W. K. Kouw, Bojan Jovanović, Liese Mebis, Yao Fu, Youquan Wang, Ola Friman, Philippe Huynen, Benjamin Hess, Qin Wu, Liivi Maddison, Jovana Stanisavljević, Marianne Bouw, Annika Reintam Blaser, Max Melchers, Maximilian Markus, Greet Van den Berghe, Adi Hadžibegović, Jonas Blixt, Joel Starkopf, Rebecka Rubenson Wahlin, Martin Padar, Anna-Liisa Voomets, Henri Cattier, Rebecca Lindström, Dong Zhang, Luping Wang, Hongxiang Li, Yucong Wang, Raul M. Sanchez Leon, Shashank Danndhiganaahalli, Vladislav Mihnovitš, Jacqueline Vilca Becerra, Pia Zetterqvist, Giorgia Perini, Bingkui Ren, Ligia C Fonseca Höflinger, Alice Efstathia Zouridaki, Davide Correnti, Marie Chaloupecká, Siying Chen, Yuping Zhang, Markéta Kaupová, Lucia Distaso, Antonietta Basta, Zakariya Bhuiyan, Anna Scholze, Samantha Cook, Romain Bonnert, Anna Grünewald, Nebojša Brezić, Anna Pörings, Claire-Anne Hurni, Linus Warner, Daniela M. Moran, Alex Schimmel, Marija Milenković, Torben Krieger, Norah Alamrey, Stefan Stanković, Uroš Ristic, Zhe Zhang, Yazir Alzoubi, Francesca Casale, Yvonne Swaen, Viveka Hambäck Hellkvist, GUTPHOS Study Group, Amalia Boeriu, Stefania Stock, Kadri Tamme
article en

Abstract

The present multicentre, prospective cohort study of intensive care unit (ICU) patients aims to validate the recently developed Gastrointestinal Dysfunction Score (GIDS) against mortality, given the absence of gold standard for respective organ dysfunction assessment. Consecutive adult patients admitted to ICUs worldwide were included from 28 ICUs worldwide between January and August 2024, with a maximum of 120 patients per site during an eight-week study period. Patients were monitored daily from ICU admission to discharge or a maximum of seven days in the ICU. Cox proportional hazards models with time-dependent covariates were used for 28- and 90-day mortality, and C-statistics to evaluate relative contribution of GIDS added to SOFA total and SOFA subscores. Binary and ordinal logistic regression were used for parenteral nutrition (PN) and ICU dependency, respectively. In total, 2679 patients from 28 sites were included. The GIDS was associated with 28- and 90-day mortality when adjusted for total SOFA score or all SOFA subscores in the full cohort analysis ( n = 2629). In the small cohort where all the variables of the GIDS were available (both intra-abdominal pressure and gastric residual volumes measured, n = 311), it associated with 28-day, but not with 90-day mortality. Adding GIDS to SOFA score slightly improved the predictive value of the latter for 28- and 90-day mortality in the full cohort analysis (C-statistic from 0.826 to 0.835 and 0.765 to 0.773, respectively). Increasing GIDS was associated with greater PN use and fewer ICU-free days. The GIDS was successfully validated against mortality and is proposed for assessment of GI dysfunction as a part of multiple organ dysfunction. The study was registered on ClinicalTrials.gov (NCT05909722) on 18.06.2023.

Critical Care
University of Foggia (IT), Houston Methodist (US), Karolinska University Hospital (SE), University of Nis (RS), University of Auckland (NZ), Inserm (FR), King Saud bin Abdulaziz University for Health Sciences (SA), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Charles University (CZ), National University of General San Martín (AR), Sichuan University (CN), University Hospitals of North Midlands NHS Trust (GB), Universitair Ziekenhuis Leuven (BE), Auckland City Hospital (NZ), Centre Hospitalier Universitaire Vaudois (CH), Tartu University Hospital (EE), TUM Klinikum (DE), Karolinska Institutet (SE), Humboldt-Universität zu Berlin (DE), Centre Hospitalier Universitaire de Besançon (FR), West China Hospital of Sichuan University (CN), North Estonia Medical Centre (EE), Stockholm South General Hospital (SE), King Abdullah International Medical Research Center (SA), Centar za Promociju Nauke (RS), Ospedale “M. Bufalini” di Cesena (IT), Hospital Clínic de Barcelona (ES), Hospital Italiano La Plata (AR), Luzerner Kantonsspital (CH), Beijing Hospital (CN), Ziekenhuis Gelderse Vallei (NL), First Hospital of Jilin University (CN), University Hospital Leipzig (DE), KAT General Hospital of Attica (GR), Keele University (GB), University of Tartu (EE), Freie Universität Berlin (DE), Medical University of Vienna (AT), Charité - Universitätsmedizin Berlin (DE), Universidad Nacional de La Plata (AR), Wageningen University & Research (NL), University of Lausanne (CH), KU Leuven (BE)
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