Categories, definition, and incidence of stress ulcers in critically ill patients

Stress ulceration with occult bleedingFecal samples with guaiac-positive test for blood15%–50%
Stress ulceration with overt gastrointestinal bleedingHematemesis, bloody nasogastric tube aspirate, or melena1.5%–8.5%
Stress ulceration with clinically important gastrointestinal bleedingOvert gastrointestinal bleeding plus 1 or more of the following within 24 hours:
  • Decrease in systolic, mean arterial blood pressure, or diastolic blood pressure of ≥ 20 mm Hg

  • Orthostatic hypotension (systolic blood pressure > 10 mm Hg) or postural tachycardia (increase in pulse ≥ 20 beats/minute)

  • Drop in hemoglobin ≥ 2 g/dL

  • Received transfusion of ≥ 2 units of packed red blood cells

  • Need for vasopressors or invasive interventions (eg, endoscopy)

  • Based on information in references 1 and 39.