02432nas a2200289   4500000000100000008004100001260001600042100001400058700001200072700001300084700001500097700001500112700001400127700001200141700001400153700001600167700001400183700001500197700001800212700001600230245010700246250001500353300001100368490000700379520171000386020004602096       2014                            d  c-80194605021 aGattas D.1 aWebb S.1 aYoung P.1 aBeasley R.1 aBellomo R.1 aBailey M.1 aSexna A1 aLitton E.1 aEastwood G.1 aForbes A.1 aPilcher D.1 aMcGuinness S.1 aMcArthur C.00aA multicentre feasibility study evaluating stress ulcer prophylaxis using hospital-based registry data  a2014/08/28  a158-630 v163 a<p>
BACKGROUND: It is unclear whether histamine-2 receptor blockers (H2RBs) or proton pump inhibitors (PPIs) are preferred for stress ulcer prophylaxis (SUP) in intensive care unit patients. Suitably powered comparative effectiveness trials are warranted. OBJECTIVE: To establish the feasibility of collecting process-of-care and outcome data relevant to a proposed interventional trial of SUP using existing databases. DESIGN, SETTING AND PARTICIPANTS: A retrospective cohort study conducted in seven Australia and New Zealand tertiary ICUs, including all patients &gt;/=18 years admitted between 1 January 2011 and 31 December 2012. MAIN OUTCOME MEASURES: Doses of dispensed PPIs and H2RBs, upper gastrointestinal bleeding events, upper respiratory tract colonisation with pathogenic bacteria, Clostridium difficile infections and inhospital mortality. RESULTS: All sites were able to contribute to the study and investigators reported that data were generally easy to obtain. A median dose/ICU of 477 g of PPIs (interquartile range [IQR], 430.5-865 g), and 408.5 g (IQR, 109-1630.2 g) of H2RBs, were dispensed over the 2 years of the study. The median proportion of patients/ICU with upper GI bleeding complicating admission was 1.4% (IQR, 0.3%-1.8%). Colonisation of the respiratory tract with gram-negative bacteria occurred in a median of 7.1% of patients/ICU (IQR, 6.3%-14.1%). Pseudomembranous colitis occurred in hospital in a median of 1.4% of patients (IQR, 0.9%-2%) and inhospital mortality was 10.6% (95% CI, 9.5%- 11.7%). CONCLUSIONS: It is feasible to use existing data sources to measure process-of-care and outcome data necessary for a registry-based interventional trial of SUP.
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