Gastrointestinal Bleeding in Critically Ill Patients

Gastrointestinal bleeding is a serious complication in critically ill patients and is associated with increased morbidity and mortality. This prospective observational cohort study will include adult patients (≥18 years) admitted to the intensive care units of Assiut University Hospitals.

Patients will be followed during their ICU stay for the occurrence of clinically important gastrointestinal bleeding (overt or occult) occurring ≥24 hours after admission. Clinical, laboratory, and treatment-related data will be collected to identify independent risk factors and to assess associated clinical outcomes.

Inclusion criteria

• - Age 18 years or older
• Admission to the intensive care unit
• Onset of gastrointestinal bleeding after ≥24 hours of ICU admission (to distinguish ICU-acquired bleeding)
• Overt gastrointestinal bleeding (hematemesis, melena, hematochezia, or bloody nasogastric aspirate) and/or occult bleeding confirmed by fecal occult blood test or endoscopy
• Written informed consent (from patient or legal representative)

Exclusion criteria

• - Age less than 18 years
• Pregnancy
• Gastrointestinal bleeding clearly due to trauma or recent gastrointestinal surgery/procedure
• Known bleeding disorder unrelated to critical illness
• Recent receipt of peptic ulcer prophylaxis (two or more doses)
• Incomplete medical records or loss to follow-up
• Refusal to participate