Related Experiment Videos
Variables associated with stress ulcer prophylaxis misuse: a retrospective analysis
Iyad A Issa1, Ola Soubra, Hania Nakkash
1Department of Internal Medicine, Division of Gastroenterology, Rafik Hariri University Hospital, Specialty Clinics Center, 4B Hamra, Beirut 2034-7304, Lebanon. Iyadissa71@gmail.com
Digestive Diseases and Sciences
|March 20, 2012
Summary
Stress ulcer prophylaxis (SUP) is frequently overused in non-intensive care unit (ICU) settings. This study found 58% of patients inappropriately received SUP, costing over $23,000 annually.
Area of Science:
- Internal Medicine
- Pharmacoeconomics
- Hospital Administration
Background:
- Stress ulcer prophylaxis (SUP) is widely used but indications in non-intensive care unit (ICU) settings are often unclear.
- Current practices for SUP in non-ICU patients appear to be based on physician judgment rather than strict guidelines.
Purpose of the Study:
- To evaluate the extent of SUP overuse on a hospital's medical floor.
- To identify factors associated with inappropriate SUP use and its financial impact.
Main Methods:
- Retrospective analysis of 320 patient charts admitted to a tertiary university hospital's medical ward over one year.
- Review of patient data to determine the appropriateness of prescribed acid suppression therapy (AST).
Main Results:
- A significant majority (92%) of patients analyzed were not eligible for SUP.
- Inappropriate SUP use was observed in 58% of cases (p = 0.015).
- Factors associated with overuse included older age, male gender, longer hospital stays, comorbidities (OR=3.27), multiple risk factors (OR=3.53), and specific medical specialties, resulting in an estimated annual cost of over $23,000.
Conclusions:
- The study confirms significant overuse and misuse of SUP on general medical floors.
- Identified patient characteristics and clinical factors contribute to inappropriate SUP prescribing, highlighting a need for revised clinical protocols.
Related Concept Videos
01:26Peptic Ulcer Disease IV: Management
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
01:30Peptic Ulcer Disease I: Introduction
Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
01:25Peptic Ulcer Disease I: Introduction
Peptic ulcer disease (PUD) involves breaks in the gastrointestinal tract's mucosal lining, primarily in the stomach and duodenum, with less frequent occurrences in the lower esophagus or near the pylorus.Ulcers can be acute or chronic. Acute ulcers are short-lived with minimal inflammation and heal quickly after the irritant is removed. Chronic ulcers persist, may recur, and often cause scarring due to ongoing tissue damage. Superficial erosions affect only the mucosal layer and are called...
01:24Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
Peptic ulcer disease, commonly called PUD, represents a multifaceted condition characterized by disruptions in the lining of the gastrointestinal (GI) tract. Central to the protection of the gastrointestinal lining is the mucosal-bicarbonate barrier. This physiological defense mechanism is a formidable shield against the corrosive effects of gastric acid and pepsin secretion in the stomach. Its role is pivotal in maintaining the structural integrity of the stomach's inner lining. Bicarbonate,...
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
01:25Peptic Ulcer Disease III: Clinical Manifestations and Complications
Duodenal UlcersDuodenal ulcers are the most common form of peptic ulcer disease, presenting with chronic, intermittent epigastric pain. Pain typically appears 2–3 hours after meals, especially when the stomach is empty, often waking patients at night. It is characteristically relieved by food or antacids (“pain–food–relief”). Some patients remain asymptomatic until complications like bleeding or perforation emerge, particularly with NSAID or anticoagulant use.Gastric UlcersGastric ulcers share...