作者
Deborah J Cook, Hugh D Fuller, Gordon H Guyatt, John C Marshall, David Leasa, Richard Hall, Timothy L Winton, Frank Rutledge, Thomas Todd, Peter Roy, Jacques Lacroix, Lauren Griffith, Andrew Willan
发表日期
1994/2/10
期刊
New England journal of medicine
卷号
330
期号
6
页码范围
377-381
出版商
Massachusetts Medical Society
简介
Background
The efficacy of prophylaxis against stress ulcers in preventing gastrointestinal bleeding in critically ill patients has led to its widespread use. The side effects and cost of prophylaxis, however, necessitate targeting preventive therapy to those patients most likely to benefit.
Methods
We conducted a prospective multicenter cohort study in which we evaluated potential risk factors for stress ulceration in patients admitted to intensive care units and documented the occurrence of clinically important gastrointestinal bleeding (defined as overt bleeding in association with hemodynamic compromise or the need for blood transfusion).
Results
Of 2252 patients, 33 (1.5 percent; 95 percent confidence interval, 1.0 to 2.1 percent) had clinically important bleeding. Two strong independent risk factors for bleeding were identified: respiratory failure (odds ratio, 15.6) and coagulopathy (odds ratio, 4.3). Of 847 patients …
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DJ Cook, HD Fuller, GH Guyatt, JC Marshall, D Leasa… - New England journal of medicine, 1994