10.6084/m9.figshare.5946376.v1
Junji Wei
Junji
Wei
Rongcai Jiang
Rongcai
Jiang
Lihong Li
Lihong
Li
Dezhi Kang
Dezhi
Kang
Guodong Gao
Guodong
Gao
Chao You
Chao
You
Jianmin Zhang
Jianmin
Zhang
Liang Gao
Liang
Gao
Qibing Huang
Qibing
Huang
Duanwu Luo
Duanwu
Luo
Gang Zhao
Gang
Zhao
Hongyi Zhang
Hongyi
Zhang
Shuo Wang
Shuo
Wang
Renzhi Wang
Renzhi
Wang
Stress-related upper gastrointestinal bleeding in adult neurocritical care patients: a Chinese multicenter, retrospective study
Taylor & Francis Group
2018
Stress ulcer bleeding
upper gastrointestinal bleeding
neurocritical care
Glasgow coma scale
H2-receptor antagonists
proton pump inhibitors
2018-03-03 06:13:13
Journal contribution
https://tandf.figshare.com/articles/journal_contribution/Stress-related_upper_gastrointestinal_bleeding_in_adult_neurocritical_care_patients_a_Chinese_multicenter_retrospective_study/5946376
<p><b>Objective:</b> China has limited data on stress-related gastrointestinal ulcers in patients admitted for neurosurgical care. This study evaluated the incidence of upper gastrointestinal bleeding (UGIB) and use of stress ulcer prophylaxis (SUP) in Chinese neurocritical care patients (Glasgow Coma Scale [GCS] score ≤10).</p> <p><b>Methods:</b> This multicenter, retrospective study was performed from January 2015 to July 2015. Medical records of 1468 patients hospitalized during 2014 were reviewed. An estimated UGIB incidence rate of 4.4% was considered for precision of 1.3% for estimation of UGIB. The primary endpoint was evaluation of overall incidence of any overt UGIB in ≤14 days after cerebral lesion. Secondary endpoints included incidence of UGIB with or and without clinically significant complications, time to UGIB, associated risk factors and SUP used.</p> <p><b>Results:</b> We analyzed 1416 patients (mean age: 53.7 ± 14.00 years; males: 62.4%) with cerebral lesions. Overall incidence rate of UGIB ≤14 days was 12.9% (95% CI: 11.2%–14.7%), 0.76% with and 12.1% without significant clinical complications. Average time and duration of bleeding were 2.9 ± 3.37 days and 4.2 ± 8.4 days, respectively. The most significant risk factors for UGIB were mechanical ventilation for >48 hours (<i>p</i> < .0001), UGIB history (<i>p</i> = .0026) and use of anticoagulants (<i>p</i> < .0001). Acid-suppression drugs were administered for SUP in 79.0% of the patients, whereas 40.5% received hemostatic drugs.</p> <p><b>Conclusions:</b> The rate of UGIB incidence was higher than the estimated rate in neurocritical care patients in China, suggesting the need for better management and treatment for stress-related mucosal disease in China. History of UGIB, mechanical ventilation and/or anticoagulants significantly affected UGIB.</p> <p><b>ClinicalTrials registry number:</b> NCT02316990.</p>