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Gastro-intestinal bleeding in 1211 ventilated trauma patients: a multivariate analysis of the risk factors
Critical Care volume 3, Article number: P190 (2000)
Aim
Anti-acid therapies are described as potential risk factors for acquired pneumonia in ICU patients. The aim of this prospective study is to assess the incidence and risk factors of gastro-intestinal bleeding (GIB) in a level 1 trauma ICU, in order to better define the populations of patients likely to benefit from such a preventive treatment.
Methods
5 year prospective study (May 1st 1993, April 30th 1998). All trauma patients admitted to ICU and ventilated for more than 2 days were included. All patients were submitted to the same diagnostic and therapeutic procedures. None of them received systematic anti-acid therapies except in the case of documented history of GIB. GIB patients (confirmed by endoscopy) were compared to all others patients (GIB-).
Results
1211 patients (age*: 38.6 ± 19.3 years, ISS**: 31 (24–41), GCS**: 7 (3–15), Coma (GCS = 8): 52%, SAPS II**: 30 (19–37), ventilation: 13.5 ± 11 days) were included. The incidence of GIB is 2.3% (n = 28). Table 1 summarizes the only significant risk factors after univariate analysis. Table 2 the final model after step-wise logistic regression.
All patients were successfully treated (medical treatment: 22, surgical treatment: 6) and the occurrence of GIB resulted in no additional mortality.
Conclusion
Unavailability of the gastro-intestinal tract, acute renal failure and spinal cord injury are important risk factors for GIB. These results emphasize the importance of early enteral feeding which certainly represents the best prevention from the occurrence of GIB.
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Petit, L., Leger, A., Masson, F. et al. Gastro-intestinal bleeding in 1211 ventilated trauma patients: a multivariate analysis of the risk factors. Crit Care 3 (Suppl 1), P190 (2000). https://doi.org/10.1186/cc563
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DOI: https://doi.org/10.1186/cc563