Objective  To explore the risk factors of stress ulcer (SU) in sepsis patients during hospitalization and its influence on the prognosis.

Methods  A total of 344 sepsis patients admitted to the Department of Emergency Intensive Care Unit (EICU) of Zhongshan Hospital, Fudan University from January 2019 to July 2021 were enrolled, and were divided into SU group and NSU group according to the presence or absence of SU. Logistic regression model was used to evaluate the risk factors of SU and 28-day death in sepsis patients, and ROC curve was used to evaluate the predictive value of related indicators for 28-day death in sepsis patients.

Results  Among 344 patients with sepsis, 80 cases (23.3%) had SU. Some pro-inflammatory cytokines (IL-6、IL-8) were significantly increased in the SU group (P < 0.05). APACHE Ⅱ score was the influence factor for SU in sepsis patients (OR=1.066, 95%CI 1.030-1.103, P < 0.001), and respiratory failure (OR=3.408, 95%CI 1.604-7.239, P < 0.001), blood urea nitrogen increasing (OR=1.046, 95%CI 1.003-1.090, P < 0.05), shock (OR=2.427, 95%CI 1.145-5.144, P < 0.05) were independent risk factors for SU in septic patients (P < 0.05). The 28-day mortality in the SU group was 26.3% (n＝21), and in the NSU group was 6.4% (n＝17, P < 0.001). APACHE Ⅱ score and the SU occurrence or not were independent influence factors for 28-day mortality of septic patients (P < 0.01). The AUC of combined SU and APACHE Ⅱ score for 28-day death of sepsis patients was 0.799 (P < 0.001).

Conclusion  The inflammatory response in sepsis patients with SU is often more severer. The occurrence of SU is affected by many factors. Early identification and correction of reversible factors may improve the prognosis of patients with sepsis.