An observational study of upper gastrointestinal bleeding in intensive care units: is Helicobacter pylori the culprit?
Related Experiment Video
Updated: Jan 21, 2026
Rapid Detection of Helicobacter pylori Virulence and Typing Using Quantum Dot Labeling Technology
Published on: June 13, 2025
Eric Maury1, Jacques Tankovic, Anne Ebel
1Service de Réanimation Médicale, Unité Inserm U444, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France.
Objective:
Upper gastrointestinal bleeding (UGIB) related to stress ulcers was formerly a fearsome complication of intensive care. The incidence of this event has decreased over the years. However, the morbidity, mortality, and causes of UGIB, particularly the etiologic role of Helicobacter pylori infection, are still controversial. Therefore, we prospectively assessed the incidence of UGIB in the intensive care unit (ICU) and evaluated the role of H. pylori infection.
Design:
A prospective observational study followed by a case-control study.
Setting:
Seven ICUs in the Paris area, five of them located in teaching hospitals.
Patients:
All patients admitted consecutively to seven ICUs during a 1-year period were monitored for signs of clinically relevant UGIB.
Interventions:
None.
Measurements And Main Results:
Only cases of endoscopically confirmed UGIB were analyzed. Patients whose hemorrhage originated from the stomach and/or duodenum were tested for H. pylori infection, by means of serology, histologic examination, and stool antigen detection. The possible association between H. pylori and UGIB was examined in a case-control study. Twenty-nine of the 4,341 patients admitted to the seven ICUs during the study period had clinically relevant, endoscopically confirmed UGIB (incidence, 0.67%; 95% confidence interval, 0.56%-0.77%). Ulcers were most frequently observed endoscopically. Patients who bled had a higher Simplified Acute Physiology Score (SAPS II) at admission (mean +/- sd, 47 +/- 14 vs. 36 +/- 28; p < .001). Despite a higher in-ICU mortality rate among patients who bled (73% vs. 16%; p < .001), death was never due to bleeding. H. pylori infection was more frequent in patients who bled than in matched controls (36% vs. 16%; p = .04).
Conclusions:
Clinically relevant, endoscopically confirmed UGIB is a rare event in the ICU setting and tends to occur in severely ill patients. H. pylori infection is more frequent in patients with gastroduodenal hemorrhage than in nonbleeding patients.
More Related Videos
04:56Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
Published on: May 16, 2025
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Related Concept Videos
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:11Observational Studies
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
03:02Measurement: Derived Units
03:38Measurement: Standard Units
01:22Bleeding in Fresh Concrete
Bleeding can cause several issues in the concrete structure. Sometimes, the rising water gets trapped beneath large aggregate...
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...