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Targeting use of acid-suppressants in hospital patients
Date:1/7/2013

Gastrointestinal bleeds which occur in the hospital, although rare, are a significant source of morbidity and mortality when they occur. Currently, the prophylactic use of acid-suppressive medication in non-critically ill patients in the hospital is not widely recommended. Despite this, these medications continue to be widely utilized for this purpose.

Shoshana Herzig from the Beth Israel Deaconess Medical Center in Massachusetts, USA, and her colleagues believe that there is a group of patients whose risk of gastrointestinal bleeds is high enough to warrant the routine prescription of acid-suppressive medication, and a larger group in whom these medications can be safely withheld. The new study, which has developed a risk scoring system to identify these patients, appears online in the Journal of General Internal Medicine, published by Springer.

Recent studies have found that the risk of gastrointestinal bleeding in hospitalized, non-critically ill patients is fairly low. However, some patients will be at greater risk for this complication than others and there is currently no method available to medical staff to help identify those most likely to have a gastrointestinal bleed. The authors therefore set out to find any potential factors which might identify which patients were most at risk to help target the use of prophylactic acid-suppressive medication where it is necessary, and withhold such medication in the rest.

Herzig and her colleagues studied 75,723 admissions to a large academic medical center over a three-year period. Patients were excluded from analysis if they were admitted with gastrointestinal bleeding, developed a bleed within one day of admission, or were due to have cardiac catheterization. There were gastrointestinal bleeds in a total of 203 patients.

From their analysis, Herzig and her colleagues identified independent risk factors which increased the likelihood of a gastrointestinal bleed. The
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Contact: Joan Robinson
joan.robinson@springer.com
49-622-148-78130
Springer
Source:Eurekalert

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