Clinical analysis of potential factors of stress ulcer in patients with multiple trauma

Objective To investigate potential risk factors of stress ulcer in patients with multiple trauma. Methods The chart records were retrospectively reviewed in 154 patients with multiple trauma admitted between September 2013 and March 2015. The patients were divided into two groups with either stress ulcer present or absent. Results The incidence of stress ulcer was 24.7% (38 of 154 patients). There was no difference in gender, age or glucocorticoid usage but the severity of shock status and use of mechanical ventilation were significantly different between the two groups (P<0.05). The APACHEⅡ score, ISS and artery lactate level were significantly higher in the stress ulcer group than those in non-stress ulcer group (17.8±5.3) mmol/L vs (15.0±3.5) mmol/L, (29.0±5.5) mmol/L vs (23.3±5.4) mmol/L, and (3.2±0.8) mmol/L vs (2.5±0.6) mmol/L, respectively (P<0.05 for all). Multivariate logistic regression analysis showed that ISS and artery lactate level were correlated with the incidence of stress ulcer. The best boundary value of ISS was 23.5 with the sensitivity, specificity, positive predictive and negative predictive values of 86.8%, 56.9%, 39.8% and 93.0% respectively. The best boundary value of lactate level was 2.75 mmol/L, and the sensitivity, specificity, positive predictive values and negative predictive values were 71.1%, 69.0%, 42.9% and 87.9%, respectively. Conclusion The incidence of stress ulcer is high in patients with multiple trauma, and ISS and arterial lactate level are independent risk factors of stress ulcer. Key words: Ulcer; Risk factors; Injury severity score