title: [Risk for the development of upper gastrointestinal bleeding in children in an intensive care unit].
abstract: BACKGROUND
  Although gastrointestinal tract bleeding can occur at any age, most studies trying to establish causes or risk factors for its development have been conducted in adults. The aim of this study was to determine risk factors in children admitted in a pediatric intensive care unit.
  
  
  METHODS
  A retrospective case-control study was conducted. Children who developed upper gastrointestinal bleeding children during their stay at the intensive care unit were considered the cases. Variables were obtained from medical records including age, sex, nutritional status, mechanical ventilation, use of nasogastric tube, development of complications, presence of coagulopathy, use of prophylaxis for upper gastrointestinal tract bleeding, fasting and use of steroids. Using a multivariate analysis, risk factors were identified, with odds ratios (OR) and 95 % confidence intervals (95 % CI) calculations.
  
  
  RESULTS
  Out of 165 patients, 58 had upper gastrointestinal bleeding (35 %). Risk factors identified were prolonged clotting times (OR = 3.35), thrombocytopenia (OR = 2.39), development of sepsis (OR = 6.74) or pneumonia (OR = 4.37). Prophylaxis for upper gastrointestinal bleeding was not a protective factor.
  
  
  CONCLUSIONS
  Upper gastrointestinal bleeding frequency in children hospitalized in an intensive care unit was high. Identifying risk factors should help to reduce upper gastrointestinal bleeding frequency.
authors.affiliation: Servicio de Gastroenterología Pediátrica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. miguel.villasis@imss.gob.mx.
authors.forename: Glenda Karina
authors.initials: GK
authors.lastname: Gutiérrez-Gutiérrez
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Villasís-Keever
authors.forename: Beatriz
authors.initials: B
authors.lastname: González-Ortiz
authors.forename: Germán
authors.initials: G
authors.lastname: Troconis-Trens
authors.forename: Dora María
authors.initials: DM
authors.lastname: Tapia-Monge
authors.forename: Judith
authors.initials: J
authors.lastname: Flores-Calderón
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D041742:Upper Gastrointestinal Tract
keywords: Child; Gastrointestinal hemorrhage; Pediatric intensive care units