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Title: A multicentre feasibility study evaluating stress ulcer prophylaxis using hospital-based registry data.
Authors: Litton, Edward;Eastwood, Glenn M;Bellomo, Rinaldo;Beasley, Richard W;Bailey, Michael J;Forbes, Andrew B;Gattas, David J;Pilcher, David V;Webb, Steven A R;McGuinness, Shay P;Saxena, Manoj K;McArthur, Colin J;Young, Paul J
Affiliation: Department of Intensive Care, Royal Perth Hospital, Perth, WA, Australia.
Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.
Medical Research Institute of New Zealand, Wellington, New Zealand.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Intensive Care Services, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Department of Intensive Care, Royal Perth Hospital, Perth, WA, Australia.
Critical Care and Trauma Division, The George Institute for Global Health, Sydney, NSW, Australia.
Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand.
Issue Date: 1-Sep-2014
Citation: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine; 16(3): 158-63
Abstract: It is unclear whether histamine-2 receptor blockers (H2RBs) or proton pump inhibitors (PPIs) are preferred for stress ulcer prophylaxis (SUP) in intensive care unit patients. Suitably powered comparative effectiveness trials are warranted.To establish the feasibility of collecting process-of-care and outcome data relevant to a proposed interventional trial of SUP using existing databases.A retrospective cohort study conducted in seven Australia and New Zealand tertiary ICUs, including all patients ≥18 years admitted between 1 January 2011 and 31 December 2012.Doses of dispensed PPIs and H2RBs, upper gastrointestinal bleeding events, upper respiratory tract colonisation with pathogenic bacteria, Clostridium difficile infections and inhospital mortality.All sites were able to contribute to the study and investigators reported that data were generally easy to obtain. A median dose/ICU of 477 g of PPIs (interquartile range [IQR], 430.5-865 g), and 408.5 g (IQR, 109-1630.2 g) of H2RBs, were dispensed over the 2 years of the study. The median proportion of patients/ICU with upper GI bleeding complicating admission was 1.4% (IQR, 0.3%-1.8%). Colonisation of the respiratory tract with gram-negative bacteria occurred in a median of 7.1% of patients/ICU (IQR, 6.3%-14.1%). Pseudomembranous colitis occurred in hospital in a median of 1.4% of patients (IQR, 0.9%-2%) and inhospital mortality was 10.6% (95% CI, 9.5%- 11.7%).It is feasible to use existing data sources to measure process-of-care and outcome data necessary for a registry-based interventional trial of SUP.
Internal ID Number: 25161016
Type: Journal Article
Subjects: Clostridium difficile
Cohort Studies
Enterocolitis, Pseudomembranous.etiology
Feasibility Studies
Histamine H2 Antagonists.therapeutic use
Hospital Records
Peptic Ulcer.prevention & control
Pneumonia, Ventilator-Associated.etiology
Proton Pump Inhibitors.therapeutic use
Retrospective Studies
Treatment Outcome
Appears in Collections:Journal articles

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