​Cook DJ, Fuller HD, Guyatt GH, et al.  Risk factors for gastrointestinal bleeding in critically ill patients. New England Journal of Medicine. 1994;330:377-381.

The authors describe a prospective multicenter cohort study evaluating risk factors for the development of stress ulceration among patients admitted to ICUs.  They also document the incidence of  “clinically important” gastrointestinal (GI) bleeding.  Both respiratory failure (odds ratio (OR) 15.6) and coagulopathy (OR 4.3) were associated with clinically important GI bleeding.  The authors conclude that prophylaxis against stress ulcers can safely be withheld from critically ill patients unless they have coagulopathy or require mechanical ventilation.

View article abstract