Frequency of Inappropriate Continuation of Acid Suppressive Therapy After Discharge in Patients Who Began Therapy in the Surgical Intensive Care Unit

Study Objective. To determine the frequency with which patients who begin to receive stress ulcer prophylaxis in the surgical intensive care unit (SICU) are discharged receiving inappropriate acid suppressive therapy (AST). Design. Prospective, observational evaluation. Setting. Level 1 trauma cente...

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Bibliographic Details
Published in:Pharmacotherapy 2008-08, Vol.28 (8), p.968-976
Main Authors: Murphy, Catherine E., Stevens, Alison M., Ferrentino, Nicholas, Crookes, Bruce A., Hebert, James C., Freiburg, Carter B., Rebuck, Jill A.
Format: Article
Language:English
Subjects:
acid suppressive therapy
Adult
Aged
Anti-Ulcer Agents - therapeutic use
antiulcer agents
AST
Biological and medical sciences
critical care
Digestive system
Female
Gastroenterology. Liver. Pancreas. Abdomen
Gastrointestinal Hemorrhage - etiology
histamine2-receptor antagonists
Humans
Intensive Care Units
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Patient Discharge
peptic ulcer
Peptic Ulcer - prevention & control
Pharmacology. Drug treatments
Prospective Studies
proton pump inhibitors
Risk Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
stress ulceration
Stress, Psychological - complications
Surgical Procedures, Operative
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Summary:Study Objective. To determine the frequency with which patients who begin to receive stress ulcer prophylaxis in the surgical intensive care unit (SICU) are discharged receiving inappropriate acid suppressive therapy (AST). Design. Prospective, observational evaluation. Setting. Level 1 trauma center and academic tertiary care hospital. Patients. A total of 248 consecutive adult patients admitted to the SICU during a 6‐month period who began to receive AST with a proton pump inhibitor or histamine2‐receptor antagonist. Measurements and Main Results. In most patients (237 [95.6%] of 248), initiation of AST was associated with one or more risk factors for gastrointestinal bleeding. Continuation of AST during hospitalization outside the SICU occurred in 215 patients (86.7%). Sixty patients (24.2%) were discharged from the hospital receiving AST: 52 patients (21.0%) went to skilled nursing facilities or rehabilitation centers, and eight (3.2%) were discharged home. Compared with those whose AST was discontinued in the hospital, patients who continued to receive AST after hospital discharge required extended mechanical ventilation (p=0.001), had twice as many risk factors for gastrointestinal bleeding (p
ISSN:0277-0008
1875-9114
DOI:10.1592/phco.28.8.968