Abstract

SOUSA, Ana C. Isabel Chora; JACINTO, Margarida Maria Maia Leonardo Pimenta; PIRES, Vitória Isabel Duarte  and  ABREU, Tiago Tribolet de. Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Non-Critically Ill Patients. Medicina Interna [online]. 2019, vol.26, n.1, pp.28-32. ISSN 0872-671X.  https://doi.org/10.24950/rspmi/original/115/1/2019.

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.

Keywords : Gastrointestinal Hemorrhage/prevention & control; Peptic Ulcer/prevention & control; Proton Pump Inhibitors.

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