Malhis Ala, Alghamdi Taghreed, Alfandi Reem, Issa Zahra AlHaj, Alanazi Hadeel, Alfintoukh Hend, Baqar Jaffer Bin, Ali Sheraz
Pharmaceutical Care Services, King Saud Medical City, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
Emergency Department, King Saud Medical City, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
J Pharm Bioallied Sci. 2019 Jan-Mar;11(1):96-101. doi: 10.4103/jpbs.JPBS_173_18.
To investigate the appropriateness of acid-suppressive therapy (AST) for stress ulcer prophylaxis (SUP) in noncritically ill hospitalized patients.
A prospective, observational study with 384 subjects was conducted between October and December 2017 in the emergency and internal medicine departments. The Herzig clinical risk scoring system and the guidelines of the American Society of Health-System Pharmacists guidelines were used to assess risk factors and determine risk scores for gastrointestinal (GI) bleeding.
The mean age of subjects was 51.9 ± 19.4 years, and 220 (57.3%) of them were males. Among the absolute risk factors, coagulopathy was observed in 2 (0.5%) patients, mechanical ventilation in 15 (3.9%), and a history of GI bleeding in 1 (0.3%). Of 384 patients with SUP, 370 (96.4%) had a clinical risk score ≤ 9 and 14 (3.6%) had a risk score between 10 and 12 for nosocomial GI bleeding. A statistically significant relationship was found between the risk factor indication and demographics.
SUP is frequently administered to noncritically ill hospitalized patients lacking risk factors for GI bleeding. Proton pump inhibitors are the overwhelming first choice of AST among prescribers. Practitioners should follow international guidelines when prescribing ASTs outside the critical-care setting.
探讨在非危重症住院患者中，抑酸治疗（AST）用于应激性溃疡预防（SUP）的合理性。
2017年10月至12月，在急诊科和内科进行了一项前瞻性观察研究，纳入384名受试者。采用赫尔齐临床风险评分系统和美国卫生系统药师协会指南评估危险因素，并确定胃肠道（GI）出血的风险评分。
受试者的平均年龄为51.9±19.4岁，其中220名（57.3%）为男性。在绝对危险因素中，2名（0.5%）患者出现凝血功能障碍，15名（3.9%）患者接受机械通气，1名（0.3%）患者有GI出血史。在384例接受SUP的患者中，370例（96.4%）的临床风险评分为≤9分，14例（3.6%）的医院获得性GI出血风险评分为10至12分。危险因素指征与人口统计学之间存在统计学上的显著关系。
在缺乏GI出血危险因素的非危重症住院患者中，SUP的使用较为频繁。质子泵抑制剂是处方医生使用AST时压倒性的首选药物。在重症监护环境之外开具AST时，从业者应遵循国际指南。
