{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T08:16:48Z","timestamp":1783325808077,"version":"3.54.6"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2027,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background and Aim<\/jats:bold>\n : Obscure gastrointestinal bleeding (OGIB) is defined as bleeding of unknown origin after comprehensive upper, lower, and small\u2010bowel evaluations. However, the incidence and predictors of rebleeding after negative comprehensive gastrointestinal evaluation remain unclear. We aimed to identify predictors of rebleeding and develop a simple risk stratification score for OGIB.\n <\/jats:p>\n \n Methods<\/jats:bold>\n : We retrospectively analyzed 226 patients diagnosed with OGIB between 2009 and 2024. The primary outcome was rebleeding during follow\u2010up. Independent predictors were identified using multivariable Cox proportional hazards analysis. A risk score was constructed from regression coefficients and evaluated using receiver operating characteristic analysis and Kaplan\u2013Meier curves.\n <\/jats:p>\n \n Results<\/jats:bold>\n : Among 226 patients, 87 (38.5%) had overt OGIB and 139 (61.5%) had occult OGIB. Rebleeding occurred in 30 (13.2%) patients. Multivariable analysis identified liver cirrhosis (\n \u03b2<\/jats:italic>\n = 0.59,\n p<\/jats:italic>\n < 0.01), overt OGIB (\n \u03b2<\/jats:italic>\n = 0.69,\n p<\/jats:italic>\n < 0.01), and aspirin use (\n \u03b2<\/jats:italic>\n = 0.51,\n p<\/jats:italic>\n = 0.02) as independent predictors. Each factor was assigned one point, yielding a 0\u20133 point score. The score showed modest discriminative ability (area under the curve = 0.68). Rebleeding rates increased progressively with increasing scores (5.6%, 17.5%, 27.3%, and 100% for scores 0, 1, 2, and 3, respectively) and were significantly higher in the high\u2010risk group (\n p<\/jats:italic>\n < 0.01).\n <\/jats:p>\n \n Conclusion<\/jats:bold>\n : Rebleeding remained clinically relevant despite comprehensive gastrointestinal evaluation. The proposed risk score provides a simple and practical tool for identifying patients at increased risk of rebleeding and may support risk\u2010adapted follow\u2010up after a negative comprehensive gastrointestinal evaluation.\n <\/jats:p>\n \n Trial Registration<\/jats:bold>\n : N\/A.\n <\/jats:p>","DOI":"10.1002\/deo2.70378","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:38:42Z","timestamp":1783323522000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Stratification for Rebleeding in Obscure Gastrointestinal Bleeding After Comprehensive Gastrointestinal Evaluation"],"prefix":"10.1002","volume":"7","author":[{"given":"Sachiyo","family":"Onishi","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiichi","family":"Otani","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Masuda","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Kojima","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Takada","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Kubota","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Ibuka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Shimizu","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Gifu University Hospital Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"issue":"10","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1055\/s-2005-870319","article-title":"ICCE Consensus for Obscure Gastrointestinal Bleeding","volume":"37","author":"Pennazio M.","year":"2005","journal-title":"Endoscopy"},{"issue":"12","key":"e_1_2_13_3_1","first-page":"2685","article-title":"Guideline for Small Intestinal Endoscopy","volume":"57","author":"Yamamoto H.","year":"2015","journal-title":"Gastroenterological Endoscopy"},{"issue":"10","key":"e_1_2_13_4_1","first-page":"1605","article-title":"Clinical Practice Guidelines for Capsule Endoscopy","volume":"67","author":"Otsuka K.","year":"2025","journal-title":"Gastroenterological Endoscopy"},{"issue":"9","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"2540","DOI":"10.1111\/jgh.15491","article-title":"The Role of Early Video Capsule Endoscopy in the Diagnosis and Prognosis of Obscure Gastrointestinal Bleeding: A Multi\u2010Center Propensity Score Matching Study","volume":"36","author":"Zhao R.","year":"2021","journal-title":"Journal of Gastroenterology and Hepatology"},{"issue":"1","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.1002\/deo2.354","article-title":"Video Capsule Endoscopy in Overt and Occult Obscure Gastrointestinal Bleeding: Insights From a Single\u2010Center, Observational Study in Japan","volume":"4","author":"Tojo A.","year":"2024","journal-title":"DEN Open"},{"issue":"12","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"3691","DOI":"10.1007\/s10620-015-3792-8","article-title":"Long\u2010Term Outcomes in Patients With Overt Obscure Gastrointestinal Bleeding After Negative Double\u2010Balloon Endoscopy","volume":"60","author":"Shinozaki S.","year":"2015","journal-title":"Digestive Diseases and 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P.","year":"2018","journal-title":"World Journal of Gastrointestinal Endoscopy"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70378","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70378","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70378","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:38:46Z","timestamp":1783323526000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70378"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2027,4]]}},"alternative-id":["10.1002\/deo2.70378"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70378","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"assertion":[{"value":"2026-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70378"}}