Supportive and Preventive Medicine
Study
Design and Population
Independent Risk Factors
for Bleeding
Notes
1999;27:2812-7
| • | Multicenter, prospective cohort |
|---|
study of 1200 mechanically
ventilated patients
| • | Randomized trial of sucralfate |
|---|
vs. ranitidine for prevention of
GI bleeding
| • | Renal failure (RR 1.16; |
|---|
95% CI, 1.01–1.32).
| • | Enteral nutrition and SUP |
|---|
with ranitidine associated
with lower incidence of
GI bleeding
Intern Med
2014;174:564-74
| • | Multicenter, retrospective |
|---|
database study of 35,312 ICU
patients
| • | SUP administered with |
|---|
histamine-2 receptor antagonist
or PPI for 48 hr
| • | Age > 50 yr |
|---|---|
| • | Male sex |
| • | Acute respiratory failure |
| • | Shock |
| • | Sepsis |
| • | Acute kidney injury |
| • | Acute or chronic hepatic |
injury
| • | Neurologic injury |
|---|---|
| • | Myocardial infarction |
| • | Coagulopathy |
| • | Unable to assess severity |
of GI bleeding outcomes
as events identified by
ICD-9 codes
Med 2015;41:833-
| • | Multicenter, prospective, |
|---|
cohort study of 1034 ICU
patients
| • | Overall, 73% received SUP |
|---|
at some point during ICU
admission, most often PPIs
| • | Renal replacement |
|---|
therapy
| • | Liver disease |
|---|---|
| • | Greater severity of illness |
| • | Coexisting or acute |
coagulopathy
GI = gastrointestinal; ICU = intensive care unit; ICD-9 = International Classification of Diseases, Ninth Revision; INR = international normalized ratio; PPI = proton
pump inhibitor; SUP = stress ulcer prophylaxis.
Information from: Cook DJ, Fuller HD, Guyatt GH, et al. Risk factors for gastrointestinal bleeding in critically ill patients. Canadian Critical Care Trials Group. N Engl
J Med 1994;330:377-81; Cook DJ, Heyland D, Griffith L, et al. Risk factors for clinically important upper gastrointestinal bleeding in patients requiring mechanical
2015;41:833-45.
2024;52(8):e421-e430. J Trauma 1995;39:289-94):
Spinal cord/head trauma
Thermal injury affecting more than 35% of total body surface area
History of GI bleed within the past year
| d. | Postoperative transplantation |
|---|
Ulcerogenic medications (nonsteroidal anti-inflammatory drugs, aspirin, corticosteroids)
Elevated intracranial pressure and cerebral vasospasm were found to be additional risk factors for
clinically important upper GI bleeds in patients with aneurysmal subarachnoid hemorrhage (Neurocrit
Care. 2021;35(1):39-45).
2018;43:108-13)