Evidence map›Paper›PMID 40189498›Full record

ArticleBMC medicine2025

Heterogeneous treatment effects of stress ulcer prophylaxis among ICU patients at risk for gastrointestinal bleeding.

Yongpeng Xie, Yao Yan, Qixiang Hong, Hui Zheng, Lijuan Cao, Xiaoming Li, Songqiao Liu, Hui Chen

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yongpeng XieDepartment of Emergency and Critical Care Medicine, the First Affiliated Hospital, The First People'S Hospital of Lianyungang, the Lianyungang Clinical College of Nanjing Medical University, Kangda College of Nanjing Medical University, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, 222000, China.
Yao YanDepartment of Emergency and Critical Care Medicine, the First Affiliated Hospital, The First People'S Hospital of Lianyungang, the Lianyungang Clinical College of Nanjing Medical University, Kangda College of Nanjing Medical University, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, 222000, China.
Qixiang HongDepartment of Emergency and Critical Care Medicine, the First Affiliated Hospital, The First People'S Hospital of Lianyungang, the Lianyungang Clinical College of Nanjing Medical University, Kangda College of Nanjing Medical University, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, 222000, China.
Hui ZhengDepartment of Emergency and Critical Care Medicine, the First Affiliated Hospital, The First People'S Hospital of Lianyungang, the Lianyungang Clinical College of Nanjing Medical University, Kangda College of Nanjing Medical University, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, 222000, China.
Lijuan CaoDepartment of Emergency and Critical Care Medicine, the First Affiliated Hospital, The First People'S Hospital of Lianyungang, the Lianyungang Clinical College of Nanjing Medical University, Kangda College of Nanjing Medical University, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, 222000, China.
Xiaoming LiDepartment of Emergency and Critical Care Medicine, the First Affiliated Hospital, The First People'S Hospital of Lianyungang, the Lianyungang Clinical College of Nanjing Medical University, Kangda College of Nanjing Medical University, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, 222000, China.
Songqiao LiuJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China. liusongqiao@ymail.com.
Hui ChenJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China. 15905162429@163.com.

Funding

Jiangsu Provincial Medical Key Laboratory ZDXYS202205Nanjing Technology Development Program ZKX24066the National Natural Science Foundation of China 82402565the Social Development Project of Jiangsu Provincial Department of Science and Technology BE2020670Zhongda Hospital Affiliated to Southeast University, Jiangsu Province High-Leve Hospital Construction Funds GSP-LCYIFH13
6 · The paper itself

Abstract

backgroundWhile randomized clinical trials of stress ulcer prophylaxis (SUP) have generally shown no overall benefit, subgroup analyses suggest the benefit or harm of SUP in specific patients, indicating heterogeneity of treatment effects (HTE). Understanding HTE is crucial for tailoring SUP to individual treatment.

methodsThis cohort study included patients admitted to intensive care unit (ICU) with at least one risk factor for clinically important gastrointestinal bleeding (GIB). The primary exposure was the use of SUP within 48 h after ICU entry; the primary outcome was 28-day mortality. We employed conventional subgroup analysis, risk-based analysis, and effect-based analysis to explore the HTE of SUP.

resultsA total of 25,475 patients were included, of whom 6199 (24.3%) received SUP, with famotidine being the most commonly prescribed (53.7%). Baseline characteristics were well-balanced between treatment groups after weighting. SUP was not associated with the 28-day mortality in the overall population (median value for the posterior distribution of the odds ratio (OR), 1.03; 95% credible interval (CrI), 0.96-1.11). In conventional subgroups, the impact of SUP on 28-day mortality varied substantially between patients with an age of higher than or equal to 77 years in comparison with other age subgroups (posterior probability of difference in OR, 99.3%), between patients with and without chronic liver disease (posterior probability of difference in OR, 99.9%), between patients with and without coagulopathy (posterior probability of difference in OR, 92.1%), and between patients with and without malignant cancer (posterior probability of difference in OR, 100%). In risk-based analysis, patients at high risk of death exhibited the highest propensity for benefit from SUP (posterior probability of an OR > 1, 1.9%). In effect-based analysis, patients with malignant cancer and a higher Charlson comorbidity index identified at high probability of benefit.

conclusionsAmong ICU patients with at least one risk factor for clinically important GIB, those who are younger, have chronic liver disease, coagulopathy, or malignant cancer are more likely to benefit from SUP.

Indexed as

Anti-Ulcer AgentsGastrointestinal HemorrhageIntensive Care UnitsPeptic UlcerAgedCohort StudiesFemaleHumansMaleMiddle AgedRisk FactorsTreatment Effect HeterogeneityTreatment OutcomeAnti-Ulcer AgentsGastrointestinal bleedingHeterogeneity of treatment effectsIntensive care unitStress ulcer prophylaxis

Identifiers

PMID40189498
PMCPMC11974205

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.