Table 3.
Patients Who Were Newly Started on PPI in Hospital (Naive Users).
| ICU | ACE | General Surgery | Orthopedic Surgery | General Medicine | Total | |
|---|---|---|---|---|---|---|
| Total number (% of total patients admitted) | 24 (17.4%) | 19 (11.8%) | 3 (2.7%) | 18 (6.2%) | 29 (4.8%) | 93 (7.1%) |
| Indication for use | ||||||
| GI bleed in hospital | 15 | 4 | 0 | 0 | 9 | 28 |
| GERD | 2 | 2 | 0 | 2 | 4 | 10 |
| NSAID use | 0 | 0 | 0 | 14 | 6 | 20 |
| Stress ulcer prophylaxis | 2 | 0 | 0 | 0 | 0 | 2 |
| Other (not indicated) | 0 | 3 | 1 | 0 | 4 | 8 |
| Unclear | 5 | 10 | 2 | 2 | 6 | 25 |
| PPI useda | ||||||
| Pantoprazole | 17 | 15 | 1 | 18 | 23 | 74 |
| Lansoprazole | 10 | 2 | 2 | 0 | 3 | 17 |
| Omeprazole | 1 | 2 | 0 | 0 | 0 | 3 |
| Rabeprazole | 0 | 0 | 0 | 0 | 3 | 3 |
| Prescriber | ||||||
| GI service | 5 | 10 | 0 | 0 | 1 | 16 |
| Other | 19 | 9 | 3 | 18 | 28 | 77 |
| Clostridium difficile Infection, n (%) | 1 | 0 | 0 | 0 | 0 | 1 |
| Using PPI | 1 | 0 | 0 | 0 | 0 | 1 |
| Severeb | 1 | 0 | 0 | 0 | 0 | 1 |
| Average duration of in-hospital PPI use (days) | 19.7 | 7.4 | 7.0 | 3.9 | 4.9 | 9.1 |
| PPI continued at discharge (% of survivors with known discharge medication) | 9/11 (82%) | 11/16 (69%) | 1/2 (50%) | 16/16 (100%) | 20/28 (71%) | 57/77 (74%) |
| Unknownc | 4 | 0 | 1 | 0 | 0 | 5 |
| Plan to reassess PPI indication (% of survivors) | 2/15 (13%) | 1/16 (6%) | 0/2 (0%) | 0/16 (0%) | 4/28 (14%) | 7/77 (9%) |
Abbreviations: ICU, intensive care unit; ACE, acute care for the elderly unit; GI, gastrointestinal; GERD, gastroesophageal reflux disease; NSAID, nonsteroidal anti-inflammatory drug; PPI, proton pump inhibitor.
a
Four patients were given more than one PPI drug, and so were included multiple times.
b
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
c
Discharge medications not found.