Appropriateness of stress ulcer prophylaxis and associated factors among patients in medical, surgical, and intensive care units at Wolaita Sodo university comprehensive specialized hospital, Ethiopia: a cross-sectional study

Abstract

Stress-related gastric ulcer (SRGU) is a common complication among critically ill patients, and inappropriate use of stress ulcer prophylaxis (SUP) remains a global challenge in hospitalized populations. This study aimed to assess the appropriateness of SUP practice and its associated factors among patients admitted to medical, surgical, and intensive care units (ICUs) at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia, in 2023. A hospital-based cross-sectional study was conducted using a retrospective chart review of 370 patients. Data were collected from July to September 2023 using a structured and pretested data abstraction tool. The data were entered into Epi Data version 4.6 and analyzed using SPSS version 25. Descriptive statistics were used to summarize patient characteristics and SUP practices. Bivariable logistic regression analysis was performed to identify candidate variables (p < 0.25), which were subsequently entered into a multivariable logistic regression model to determine factors independently associated with inappropriate SUP use. Statistical significance was declared at p < 0.05. Of the 370 patients included in the analysis, 232 (62.7%) received SUP inappropriately. Factors independently associated with inappropriate SUP use included hospital stay longer than seven days (AOR = 2.50; 95% CI: 1.42–4.39), absence of hypoperfusion (AOR = 0.35; 95% CI: 0.22–0.58), mechanical ventilation for more than 48 h (AOR = 3.88; 95% CI: 1.90–7.92), and delayed initiation of SUP (> 1 day after admission) (AOR = 0.34; 95% CI: 0.20–0.58). The prevalence of inappropriate SUP use was high in the study setting. Implementation of institutional guidelines, targeted prescriber training, and pharmacist-led stewardship interventions are recommended to promote appropriate SUP utilization.