title: Variables associated with stress ulcer prophylaxis misuse: a retrospective analysis.
abstract: BACKGROUND
  Stress ulcer prophylaxis (SUP) is commonly used in hospitals. Although its indications are better delineated for intensive care unit (ICU) patients, its use in non-ICU settings is somewhat arbitrary and based on judgment.
  
  
  OBJECTIVE
  We attempted to assess the extent of SUP overuse in our hospital. We also carefully collected and analyzed several variables to detect associations governing this flawed behavior and its financial burden on the hospital's budget.
  
  
  METHODS
  We retrospectively analyzed charts of patients admitted to the medical floor of a tertiary referral university hospital over a 1 year period. All adult patients admitted to the medical ward who received at least one dose of SUP were included and reviewed for a multitude of variables in addition to the appropriateness of acid suppression therapy (AST).
  
  
  RESULTS
  We included 320 charts and found that 92% of patients admitted during that period were not eligible for SUP. The total inappropriateness of SUP was noted to be 58% (p = 0.015). Increasing age and male gender were found to be significant variables in AST misuse (p = 0.045 and p = 0.010), much like duration of hospital stay (p = 0.008). Comorbidities was also found to be a defining variable for AST overuse (odds ratio [OR] = 3.27). Patients with two or more minor risk factors were also subjected more to SUP inappropriately (OR = 3.53), in addition to patients of certain specialties (Neurology, Infectious Diseases, etc.). Our calculated financial burden was more than $23,000 per year for the medical floor.
  
  
  CONCLUSIONS
  This retrospective study confirmed the growing suspicion that SUP misuse is evident on the medical floors. We also delineated several factors and variables associated with and affecting SUP overuse.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Rafik Hariri University Hospital, Specialty Clinics Center, 4B Hamra, Beirut 2034-7304, Lebanon. Iyadissa71@gmail.com
authors.forename: Iyad A
authors.initials: IA
authors.lastname: Issa
authors.forename: Ola
authors.initials: O
authors.lastname: Soubra
authors.forename: Hania
authors.initials: H
authors.lastname: Nakkash
authors.forename: Lama
authors.initials: L
authors.lastname: Soubra
mesh_terms: D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D004363:Drug Utilization / Q000191:economics; D005260:Female; D006757:Hospital Units; D006801:Humans; D057970:Inappropriate Prescribing / Q000191:economics; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010437:Peptic Ulcer / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013312:Stress, Physiological / Q000502:physiology*
chemical_list: D000897:Anti-Ulcer Agents