Stress Ulceration What is the Incidence?

The incidence of stress ulceration is diminishing, probably reflecting better care before and during intensive care admission.

In the 1970s and 80s, meta analyses have put the incidence of overt bleeding to be approximately 15% (6). The prevalence appears to be diminishing. Work by Cooke and colleagues ascribed the risk of overt bleeding to be 4.4% and clinically significant bleeding to be 1.5% (2)The incidence of clinically significant bleeding appears to be dependent on severity of illness and the type of patient population studied. For example, in Perioperative cardiac surgery patients the risk is approximately 0.4% (7). In stroke patients (who were not mechanically ventilated) the risk is 0.1% (8). There is a strong relationship between duration of mechanical ventilation, duration of intensive care stay, and incidence of ulceration: patients without coagulopathy and mechanical ventilation had an incidence of bleeding of 0.1% in the earlier Cooke study (2). Again, duration of care and mechanical ventilation represent markers of severity of illness rather than direct causes of ulceration.

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