Review文献1995 A Risk Analysis of Stress Ulceration after Trauma.pdfVIP

The Journal of Trauma: Injury, Infection, and Critical Care Issue: Volume 39(2), August 1995, pp 289-294 Copyright: © Williams Wilkins 1995. All Rights Reserved. Publication Type: [Paper] ISSN: 0022-5282 Accession:199508000-00017 [Paper]◀ Previous Article | Table of Contents | Next Article ▶ A Risk Analysis of Stress Ulceration after Trauma Simons, Richard K. MB, BChir, FRCS, FACS; Hoyt, David B. MD, FACS; Winchell, Robert J. MD, FACS; Holbrook, Troy PhD; Eastman, A. Brent MD, FACS Author Information From the Department of Surgery (R.K.S., D.B.H., R.J.W., T.H.), Division of Trauma, University of California-San Diego, San Diego, California; and Scripps Memorial Hospital (A.B.E.), La Jolla, California. Presented at the 54th Annual Meeting of the American Association for the Surgery of Trauma, September 29-October 1, 1994, San Diego, California. Address for reprints: Richard K. Simons, MB, BChir, FRCS, FACS, Division of Trauma, 8896, University of California-San Diego Medical Center, 200 West Arbor Street, San Diego, CA 92103-8896. Abstract Prophylaxis for stress ulceration is considered standard care for most critically ill patients, but may be overutilized. We determined the incidence of stress ulceration in 33,637 major trauma patients treated in a regionalized trauma system from 1985 to 1991 using trauma registry data and chart review. Injury-related risk factors for stress ulceration and other associated infectious and organ failure complications were identified by regression analysis. Clinical stress ulceration developed in 57 patients (0.17%) despite prophylaxis. Eighteen patients (0.05%) developed severe ulceration with either gastroduodenal perforation (3 patients) or a 2 U blood transfusion requirement (16 patients). Independent risk factors with odds ratios (OR) were identified as follows: Injury Severity Score (ISS) greater than or equal to 16, OR = 12.6; spinal cord injury, OR = 2.0; and age