Sepsis as a Potential Risk Factor for Upper Gastrointestinal Bleeding in Critically Ill Patients: A Systematic Review and Meta-analysis

Author:

Yao Yanfen12,Ba Tejin3,Bao Bagenna3,Zhang Shuanglin3,Kong Li24ORCID

Affiliation:

1. Department of Intensive Care Medicine, Shandong Provincial Third Hospital, Shandong University, Jinan, China

2. The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China

3. Department of Emergency, International Mongolian Hospital of Inner Mongolia, Hohhot, China

4. Department of Emergency Center, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China

Abstract

Purpose: Sepsis is a common and critical condition in intensive care units (ICUs) known to complicate patient outcomes. Previous studies have indicated an association between sepsis and various ICU morbidities, including upper gastrointestinal bleeding (UGIB). However, the extent of this relationship and its implications in ICU settings remain inadequately quantified. This study aims to elucidate the association between sepsis and the risk of UGIB in ICU patients. Methods: A comprehensive meta-analysis was conducted, encompassing nine studies with a total of nearly 9000 participants. These studies reported events for both sepsis and nonsepsis patients separately. Pooled odds ratios (ORs) were calculated to assess the risk of UGIB in septic versus nonseptic ICU patients. Subgroup analyses were conducted based on age and study design, and both unadjusted and adjusted ORs were examined. Results: The pooled OR indicated a significant association between sepsis and UGIB (OR = 3.276, 95% CI: 1.931 to 5.557). Moderate heterogeneity was observed (I² = 43.9%). The association was significant in adults (pooled OR = 4.083) but not in children. No difference in association was found based on the study design. Unadjusted and adjusted ORs differed slightly, indicating the influence of confounding factors. Conclusion: This meta-analysis reveals a significant association between sepsis and an increased risk of UGIB in ICU patients, particularly in adults. These findings highlight the need for vigilant monitoring and proactive management of septic ICU patients to mitigate the risk of UGIB. Future research should focus on understanding the underlying mechanisms and developing tailored preventive strategies.

Funder

Shandong Province Traditional Chinese Medicine Science and Technology Youth Project

Shandong Province Traditional Chinese Medicine Science and Technology Key Project

National Natural Science Foundation of China

China International Medical Foundation Youth Medical Research Special Fund

Publisher

SAGE Publications

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