Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/1684
Título: Stress-Related Mucosal Disease: Incidence of Bleeding and the Role of Omeprazole in its Prophylaxis
Autor: Amaral, M
Favas, C
Delgado Alves, J
Riso, N
Vaz Riscado, M
Palavras-chave: HCC MED
Anti-Ulcer Agents/administration & dosage
Gastric Mucosa/drug effects
Gastrointestinal Hemorrhage/epidemiology
Gastrointestinal Hemorrhage/prevention & control
Omeprazole/administration & dosage
Risk Factors
Stress, Psychological/epidemiology
Upper Gastrointestinal Tract/drug effects
Data: 2010
Editora: Elsevier
Citação: Eur J Intern Med. 2010 Oct;21(5):386-8
Resumo: BACKGROUND: Upper gastrointestinal bleeding is the severe complication of stress-related mucosal disease in hospitalized patients. In intensive care units (ICU), risk factors are well defined and only mechanical ventilation and coagulopathy proved to be relevant for significant bleeding. On the contrary, in non-ICU settings there is no consensus about this issue. Nevertheless, omeprazole is still widely used in prophylaxis of bleeding. The objective of our study was to evaluate the relevance of stress-related mucosal disease bleeding in patients admitted to an internal medicine ward, and the role of omeprazole in its prophylaxis. METHODS: We conducted a retrospective study in which we analysed consecutive patients who were admitted to our ward over a year. We recorded demographic characteristics of the patients, potential risk factors for stress-related mucosal disease (clinical data, laboratory, and medication), administration of prophylactic omeprazole, and total cost of this prophylaxis. Patients with active gastrointestinal bleeding on the admission were excluded. We recorded every upper gastrointestinal bleeding event with clinical relevance. RESULTS: Five hundred and thirty-five patients, mean age 70 years, mean length of stay 9.6+/-7.7 days; 140 (26.2%) patients were treated with 40 mg of omeprazole intravenously, 193 (36.1%) with 20mg of omeprazole orally, and 202 (37.8%) patients had no prophylaxis. There was only one episode (0.2%) of clinically relevant bleeding. CONCLUSION: In patients admitted to an internal medicine ward, incidence of upper gastrointestinal bleeding as a complication of stress-related mucosal disease is low. We found that there is no advantage in prophylaxis with omeprazole.
Peer review: yes
URI: http://hdl.handle.net/10400.17/1684
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