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Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital

INTRODUCTION: Stress ulcer prophylaxis (SUP) has been a widespread practice both in intensive care units (ICU) and internal wards at the beginning of the twenty-first century. Clinical data suggests an important overuse of acid suppressive therapy (AST) for this indication. Data on current clinical...

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Autores principales: Rauch, Julia, Patrzyk, Maciej, Heidecke, Claus-Dieter, Schulze, Tobias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803691/
https://www.ncbi.nlm.nih.gov/pubmed/34518899
http://dx.doi.org/10.1007/s00423-021-02325-3
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author Rauch, Julia
Patrzyk, Maciej
Heidecke, Claus-Dieter
Schulze, Tobias
author_facet Rauch, Julia
Patrzyk, Maciej
Heidecke, Claus-Dieter
Schulze, Tobias
author_sort Rauch, Julia
collection PubMed
description INTRODUCTION: Stress ulcer prophylaxis (SUP) has been a widespread practice both in intensive care units (ICU) and internal wards at the beginning of the twenty-first century. Clinical data suggests an important overuse of acid suppressive therapy (AST) for this indication. Data on current clinical practice of SUP in surgical patients in a non-ICU setting are spares. In the light of a growing number of reports on serious side effects of AST, this study evaluates the use of AST for SUP in a normal surgical ward in a German university hospital. METHODS: Between January 2016 and June 2016, SUP was analysed retrospectively in 1132 consecutive patients of the Department of Surgery of the Universitätsmedizin Greifswald. RESULTS: The patients managed with and without SUP were similar with respect to demographic data and treatment with anticoagulants, SSRI and glucocorticoids. Patients with SUP were treated more frequently by cyclooxygenase inhibiting drugs (NSAID, COX2-inhibitors), were more frequently treated in the intermediated care unit and had a longer hospital stay. Risk factors for the development of stress ulcers were similarly present in patient groups managed with and without SUP. About 85.7–99.6% of patients were given SUP without an adequate risk for stress ulcer development, depending on the method used for risk assessment. DISCUSSION: Still today, SUP is widely overused in non-ICU surgical patients. Information campaigns on risk factors for stress ulcer development and standard operating procedures for SUP are required to limit potential side effects and increased treatment costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00423-021-02325-3.
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spelling pubmed-88036912022-02-02 Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital Rauch, Julia Patrzyk, Maciej Heidecke, Claus-Dieter Schulze, Tobias Langenbecks Arch Surg Original Article INTRODUCTION: Stress ulcer prophylaxis (SUP) has been a widespread practice both in intensive care units (ICU) and internal wards at the beginning of the twenty-first century. Clinical data suggests an important overuse of acid suppressive therapy (AST) for this indication. Data on current clinical practice of SUP in surgical patients in a non-ICU setting are spares. In the light of a growing number of reports on serious side effects of AST, this study evaluates the use of AST for SUP in a normal surgical ward in a German university hospital. METHODS: Between January 2016 and June 2016, SUP was analysed retrospectively in 1132 consecutive patients of the Department of Surgery of the Universitätsmedizin Greifswald. RESULTS: The patients managed with and without SUP were similar with respect to demographic data and treatment with anticoagulants, SSRI and glucocorticoids. Patients with SUP were treated more frequently by cyclooxygenase inhibiting drugs (NSAID, COX2-inhibitors), were more frequently treated in the intermediated care unit and had a longer hospital stay. Risk factors for the development of stress ulcers were similarly present in patient groups managed with and without SUP. About 85.7–99.6% of patients were given SUP without an adequate risk for stress ulcer development, depending on the method used for risk assessment. DISCUSSION: Still today, SUP is widely overused in non-ICU surgical patients. Information campaigns on risk factors for stress ulcer development and standard operating procedures for SUP are required to limit potential side effects and increased treatment costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00423-021-02325-3. Springer Berlin Heidelberg 2021-09-14 2021 /pmc/articles/PMC8803691/ /pubmed/34518899 http://dx.doi.org/10.1007/s00423-021-02325-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Rauch, Julia
Patrzyk, Maciej
Heidecke, Claus-Dieter
Schulze, Tobias
Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital
title Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital
title_full Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital
title_fullStr Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital
title_full_unstemmed Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital
title_short Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital
title_sort current practice of stress ulcer prophylaxis in a surgical patient cohort in a german university hospital
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803691/
https://www.ncbi.nlm.nih.gov/pubmed/34518899
http://dx.doi.org/10.1007/s00423-021-02325-3
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