Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2019000100007 |
Resumo: | Introduction: The use of proton pump inhibitors (PPIs) has a well-established role in the prophylaxis of gastrointestinal bleeding in critically care patients; however, its use in non-intensive care patients is controversial. The authors proposed to evaluate the prescription of PPIs as gastrointestinal bleeding prophylaxis during hospitalization of non-critically ill patients, including the indication and costs. Material and Methods: A prospective, observational, cross-sectional study. All patients admitted to our medical department during a 31 day period were included. At the time of admission, a gastrointestinal bleeding risk score was completed by the attending physician. A score equal or greater than 10 points identified appropriateness of PPIs for prophylactic therapy. Costs with PPI use were collected on the study period. Results: During the study period, 115 patients were admitted, of which 99 were included in the study (54.5% women, mean age 76.2 years). Of the gastrointestinal bleeding risk factors assessed: 28.3% acute kidney injury, 10.1% liver disease, 20.2% sepsis, 40.4% prophylactic anticoagulation, and 30.3% coagulopathy. According to the score used, 67.7% of the patients were in low or low-medium risk and 32.4% in high-medium or high risk. During hospitalization, 59.6% of the patients received PPIs, 45.8% of which inappropriately according to the risk score. The total cost of PPIs use was 101.9, with an inappropriate spending of 46.6 during a 31 day period in our Internal Medicine department alone. Conclusion: PPIs use was prevalent in non-critically ill patients (59.6%), of which 45.8% were inappropriate, representing a problem associated with iatrogenic risk and economic impact. |
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Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill PatientsGastrointestinal Hemorrhage/prevention & controlPeptic Ulcer/prevention & controlProton Pump InhibitorsIntroduction: The use of proton pump inhibitors (PPIs) has a well-established role in the prophylaxis of gastrointestinal bleeding in critically care patients; however, its use in non-intensive care patients is controversial. The authors proposed to evaluate the prescription of PPIs as gastrointestinal bleeding prophylaxis during hospitalization of non-critically ill patients, including the indication and costs. Material and Methods: A prospective, observational, cross-sectional study. All patients admitted to our medical department during a 31 day period were included. At the time of admission, a gastrointestinal bleeding risk score was completed by the attending physician. A score equal or greater than 10 points identified appropriateness of PPIs for prophylactic therapy. Costs with PPI use were collected on the study period. Results: During the study period, 115 patients were admitted, of which 99 were included in the study (54.5% women, mean age 76.2 years). Of the gastrointestinal bleeding risk factors assessed: 28.3% acute kidney injury, 10.1% liver disease, 20.2% sepsis, 40.4% prophylactic anticoagulation, and 30.3% coagulopathy. According to the score used, 67.7% of the patients were in low or low-medium risk and 32.4% in high-medium or high risk. During hospitalization, 59.6% of the patients received PPIs, 45.8% of which inappropriately according to the risk score. The total cost of PPIs use was 101.9, with an inappropriate spending of 46.6 during a 31 day period in our Internal Medicine department alone. Conclusion: PPIs use was prevalent in non-critically ill patients (59.6%), of which 45.8% were inappropriate, representing a problem associated with iatrogenic risk and economic impact.Sociedade Portuguesa de Medicina Interna2019-03-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2019000100007Medicina Interna v.26 n.1 2019reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2019000100007Sousa,Ana C. Isabel ChoraJacinto,Margarida Maria Maia Leonardo PimentaPires,Vitória Isabel DuarteAbreu,Tiago Tribolet deinfo:eu-repo/semantics/openAccess2024-02-06T17:08:15Zoai:scielo:S0872-671X2019000100007Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:20:48.915112Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients |
title |
Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients |
spellingShingle |
Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients Sousa,Ana C. Isabel Chora Gastrointestinal Hemorrhage/prevention & control Peptic Ulcer/prevention & control Proton Pump Inhibitors |
title_short |
Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients |
title_full |
Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients |
title_fullStr |
Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients |
title_full_unstemmed |
Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients |
title_sort |
Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients |
author |
Sousa,Ana C. Isabel Chora |
author_facet |
Sousa,Ana C. Isabel Chora Jacinto,Margarida Maria Maia Leonardo Pimenta Pires,Vitória Isabel Duarte Abreu,Tiago Tribolet de |
author_role |
author |
author2 |
Jacinto,Margarida Maria Maia Leonardo Pimenta Pires,Vitória Isabel Duarte Abreu,Tiago Tribolet de |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Sousa,Ana C. Isabel Chora Jacinto,Margarida Maria Maia Leonardo Pimenta Pires,Vitória Isabel Duarte Abreu,Tiago Tribolet de |
dc.subject.por.fl_str_mv |
Gastrointestinal Hemorrhage/prevention & control Peptic Ulcer/prevention & control Proton Pump Inhibitors |
topic |
Gastrointestinal Hemorrhage/prevention & control Peptic Ulcer/prevention & control Proton Pump Inhibitors |
description |
Introduction: The use of proton pump inhibitors (PPIs) has a well-established role in the prophylaxis of gastrointestinal bleeding in critically care patients; however, its use in non-intensive care patients is controversial. The authors proposed to evaluate the prescription of PPIs as gastrointestinal bleeding prophylaxis during hospitalization of non-critically ill patients, including the indication and costs. Material and Methods: A prospective, observational, cross-sectional study. All patients admitted to our medical department during a 31 day period were included. At the time of admission, a gastrointestinal bleeding risk score was completed by the attending physician. A score equal or greater than 10 points identified appropriateness of PPIs for prophylactic therapy. Costs with PPI use were collected on the study period. Results: During the study period, 115 patients were admitted, of which 99 were included in the study (54.5% women, mean age 76.2 years). Of the gastrointestinal bleeding risk factors assessed: 28.3% acute kidney injury, 10.1% liver disease, 20.2% sepsis, 40.4% prophylactic anticoagulation, and 30.3% coagulopathy. According to the score used, 67.7% of the patients were in low or low-medium risk and 32.4% in high-medium or high risk. During hospitalization, 59.6% of the patients received PPIs, 45.8% of which inappropriately according to the risk score. The total cost of PPIs use was 101.9, with an inappropriate spending of 46.6 during a 31 day period in our Internal Medicine department alone. Conclusion: PPIs use was prevalent in non-critically ill patients (59.6%), of which 45.8% were inappropriate, representing a problem associated with iatrogenic risk and economic impact. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-03-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2019000100007 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2019000100007 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2019000100007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
dc.source.none.fl_str_mv |
Medicina Interna v.26 n.1 2019 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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