Stress ulcer prophylaxis in trauma patients

Area of Science:

• Critical Care Medicine
• Gastroenterology
• Trauma Surgery

Background:

• Unresolved issues persist regarding stress ulcer prophylaxis, especially in trauma patients.
• Lack of trials with clinically significant bleeding endpoints complicates prophylaxis decisions.
• Prescribing practices for stress ulcer prophylaxis in US Level I trauma centers were assessed due to lack of consensus.

Purpose of the Study:

• To assess current prescribing practices for stress ulcer prophylaxis at Level I trauma centers in the United States.
• To identify preferred medications and evaluation methods for stress ulcer prophylaxis.
• To understand the extent of stress ulcer prophylaxis use in trauma patients.

Main Methods:

• A survey was developed to gather data on institutional prescribing and evaluation of stress ulcer prophylaxis.
• The survey targeted 188 Level I trauma centers in the United States.
• A response rate of 63% was achieved with 119 surveys returned.

Main Results:

• 86% of centers use stress ulcer prophylaxis for most trauma patients in the ICU.
• 65% have a preferred medication, with histamine-2 blockers being the most popular (71%).
• 39% of institutions continue prophylaxis for over 50% of patients post-ICU discharge.

Conclusions:

• A lack of consensus on appropriate stress ulcer prophylaxis is evident among Level I trauma centers.
• Histamine-2 blockers are the most commonly preferred agent where a specific medication is chosen.
• Current practices indicate significant variability in stress ulcer prophylaxis management for trauma patients.