Table 2.
Patients Who Were Using PPI Prior to Hospitalization (Non-Naive Users).
| ICU | ACE | General Surgery | Orthopedic Surgery | General Medicine | Total | |
|---|---|---|---|---|---|---|
| Total number (% of total patients admitted) | 42 (30.4%) | 47 (29.2%) | 28 (24.7%) | 77 (26.6%) | 183 (30.2%) | 377 (28.8%) |
| Indication for use, n | ||||||
| GERD | 10 | 17 | 14 | 41 | 71 | 153 |
| NSAID use | 6 | 0 | 2 | 10 | 41 | 59 |
| Peptic ulcer disease | 1 | 1 | 1 | 2 | 7 | 12 |
| Previous GI bleed | 4 | 6 | 1 | 4 | 4 | 19 |
| Barrett’s esophagus | 1 | 0 | 1 | 0 | 3 | 5 |
| Other (not indicated) | 8 | 1 | 5 | 9 | 14 | 37 |
| Unclear indication | 12 | 22 | 4 | 11 | 43 | 92 |
| PPI used, n | ||||||
| Pantoprazole | 31 | 28 | 19 | 51 | 121 | 250 |
| Omeprazole | 2 | 6 | 3 | 8 | 36 | 55 |
| Lansoprazole | 5 | 6 | 3 | 8 | 12 | 34 |
| Rabeprazole | 3 | 5 | 1 | 6 | 10 | 25 |
| Dexlansoprazole | 0 | 0 | 1 | 2 | 1 | 4 |
| Esomeprazole | 1 | 2 | 1 | 2 | 3 | 9 |
| Clostridium difficile infection | 2 | 4 | 0 | 1 | 4 | 11 |
| Using PPI | 2 | 2 | 0 | 1 | 4 | 9 |
| Severea | 0 | 1 | 0 | 1 | 2 | 4 |
| PPI continued in hospital, n (% of users)b | 35 (83%) | 36 (77%) | 22 (79%) | 66 (86%) | 167 (91%) | 326 (87%) |
| PPI continued at discharge (% of survivors) | 27/31 (87%) | 31/44 (72%) | 27/28 (96%) | 70/75 (93%) | 164/176 (93%) | 319/354 (90%) |
| Plan to reassess PPI indication (% of survivors) | 1/31 (3%) | 1/44 (2%) | 0/28 (0%) | 1/75 (1%) | 2/176 (1%) | 5/354 (1%) |
Abbreviations: ICU, intensive care unit; ACE, acute care for the elderly unit; GERD, gastroesophageal reflux disease; NSAID, nonsteroidal anti-inflammatory drug; GI, gastrointestinal; PPI, proton pump inhibitor.
a
Severe Clostridium difficile was defined as blood cell count >15 000 cells/mm3, or serum creatinine >132 mmol/L or greater than 1.5 times the patients’ baseline.13
b
Same or different PPI drug.