Objectives: The Surviving Sepsis Campaign Guidelines recommend stress ulcer prophylaxis for patients with severe sepsis who have bleeding risks. Although sepsis has been considered as a risk factor for gastrointestinal bleeding, the effect of stress ulcer prophylaxis has not been studied in patients with severe sepsis. Furthermore, stress ulcer prophylaxis may be associated with an increased risk of hospital-acquired pneumonia or Clostridium -difficile infection. The aim of this study was to investigate the risks and benefits of stress ulcer prophylaxis for patients with severe sepsis. Design: Retrospective cohort study. Setting: Five hundred twenty-six acute care hospitals in Japan. Patients: A total of 70,862 patients with severe sepsis. Interventions: None. Measurements and Main Results: One-to-one propensity score matching created 15,651 pairs of patients who received stress ulcer prophylaxis within 2 days of admission and those who did not. Patient characteristics were well balanced between the two groups. No significant differences were seen between the stress ulcer prophylaxis group and the control group with regard to -gastrointestinal bleeding requiring endoscopic hemostasis (0.6% vs 0.5%; p = 0.208), 30-day mortality (16.4% vs 16.9%; p = 0.249), and Clostridium difficile infection (1.4% vs 1.3%; p = 0.588). The stress ulcer prophylaxis group had a significantly higher proportion of hospital-acquired pneumonia (3.9% vs 3.3%; p = 0.012) compared with the control group. Conclusions: Since the rate of gastrointestinal bleeding requiring endoscopic hemostasis is not different comparing patients with and without stress ulcer prophylaxis, and the increase in hospital-acquired pneumonia is significant, routine stress ulcer prophylaxis for patients with severe sepsis may be unnecessary. Copyright (C) by 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/1S55GAL
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Publication date: Available online 7 July 2018 Source: The Journal of Emergency Medicine Author(s): Audrey Uong, Ariel Brandwein, Colin C...
-
Abstract Malignant brain tumors are rapidly progressive and often fatal owing to resistance to therapies and based on their complex biolog...
-
Abstract Background Bone flap resorption (BFR) is the most prevalent complication resulting in autologous cranioplasty failure, but no c...
-
Injury from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/1ULgTKC
-
Abstract Non-tumoral portal vein thrombosis (PVT) remains a highly relevant topic in the field of hepatology and liver transplantation wit...
-
Oral Candida colonization in xerostomic post‐radiotherapy head and neck cancer patients 16h ... Oral Candida colonization in xerostomic post...
-
Abstract Objectives Tumor invasion into blood and/or lymphatic vessels, perineural invasion, and histopathological grading are evaluated...
-
Abstract Many methods exist for generating keyframe summaries of videos. However, relatively few methods consider on-line summarisation, w...
-
Abstract Introduction Identifying occurrences of medication side effects and adverse drug events (ADEs) is an important and challenging ...
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου