Certain risk factors may predispose a patient in the intensive care unit (ICU) for mucosal stress ulcerations that result in gastrointestinal hemorrhage. These patients may benefit from closer monitoring for bleeding and prophylaxis.
Risk factors for stress ulceration for a patient in the ICU:
(1) mechanical ventilation
(2) coagulopathy
(3) head injury with Glasgow coma score <= 10 or inability to obey simple commands
(4) thermal burn involving > 35% of body surface area
(5) partial hepatectomy
(6) transplantation patient perioperatively
(7) multiple trauma with injury severity score >= 16
(8) spinal cord injury
(9) hepatic failure
(10) past history of gastric ulceration or gastric bleeding during the year prior to admission
(11) 2 or more of the following findings: ICU stay > 7 days, sepsis, use of high-dose corticosteroids (equivalent to > 250 mg per day of hydrocortisone), or occult or overt bleeding for >= 6 days
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