Application of bleeding prophylactic criteria (NICE) in patients with acute gastrointestinal bleeding. A Swiss prospective study.
Multiple treatment guidelines for nonsteroidal anti-inflammatory drugs (NSAIDs) suggest that patients with one or more risk factors for NSAID-related ulcer complications should be prescribed preventive strategies such as acid-suppressive drugs, misoprostol or COX-2-specific inhibitors to reduce their risk of serious ulcer complications. However data are lacking as to how many patients have been on preventive measures in accordance to the National Institute for Clinical Excellence (NICE) criteria in our population. We therefore evaluated the extent to which patients with acute gastrointestinal bleeding have been under ulcer-preventive strategies at the time of hospital entry. In a one-year-bleeding-study at the Waid city hospital, Zürich, ulcer preventive treatment was practiced in only 25% of 214 patients with acute gastrointestinal bleeding. We conclude that ulcer prevention in everyday medical practice is still being seldom applied.
Geyer
Martin
M
Department of Internal Medicine, City Hospital Waid, Zurich, Switzerland. geyer@gastroenterologie-wettingen.ch
Peter
Shajan
S
Bühler
Hugo
H
Bertschinger
Philipp
P
D000208:Acute Disease; D000368:Aged; D000863:Antacids / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D018890:Chemoprevention; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000517:prevention & control*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D016595:Misoprostol / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome
D000863:Antacids; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D052246:Cyclooxygenase 2 Inhibitors; D016595:Misoprostol