• Meredith G Vanstone, Karla Krewulak, Shipra Taneja, Marilyn Swinton, Kirsten Fiest, BurnsKaren E AKEAInterdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, Canada., Sylvie Debigare, Joanna C Dionne, Gordon Guyatt, John C Marshall, John G Muscedere, Adam M Deane, Simon Finfer, John A Myburgh, Audrey Gouskos, Bram Rochwerg, Ian Ball, Tina Mele, Daniel J Niven, Shane W English, Madeleine Verhovsek, Deborah J Cook, and Canadian Critical Care Trials Group.
• Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
• J Crit Care. 2024 Jun 1; 81: 154761154761.

IntroductionThe objective of this study was to create a definition of patient-important upper gastrointestinal bleeding during critical illness as an outcome for a randomized trial.DesignThis was a sequential mixed-methods qualitative-dominant multi-center study with an instrument-building aim. In semi-structured individual interviews or focus groups we elicited views from survivors of critical illness and family members of patients in the intensive care unit (ICU) regarding which features indicate important gastrointestinal bleeding. Quantitative demographic characteristics were collected. We analyzed qualitative data using inductive content analysis to develop a definition for patient-important upper gastrointestinal bleeding.SettingCanada and the United States.Participants51 ICU survivors and family members of ICU patients.ResultsParticipants considered gastrointestinal bleeding to be important if it resulted in death, disability, or prolonged hospitalization. The following also signaled patient-important upper gastrointestinal bleeding: blood transfusion, vasopressors, endoscopy, CT-angiography, or surgery. Whether an intervention evinced concern depended on its effectiveness, side-effects, invasiveness and accessibility; contextual influences included participant familiarity and knowledge of interventions and trust in the clinical team.ConclusionsSurvivors of critical illness and family members described patient-important upper gastrointestinal bleeding differently than current definitions of clinically-important upper gastrointestinal bleeding.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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