{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:02:59Z","timestamp":1788238979897,"version":"build-2803163510"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Gastrointestinal bleeding in patients with continuous-flow left ventricular assist devices (CF-LVAD) impairs quality of life and increases hospitalization rate. The Utah Bleeding Risk Score (UBRS) has been created to predict gastrointestinal bleeding (GIB) in patients on left ventricular assist device. We here aimed to externally validate UBRS on our cohort of CF-LVAD patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Utah Bleeding Risk Score was calculated, GIB events summarized on follow-up and patients stratified into 3 risk groups. Predictive ability of UBRS was examined at 3 years and during whole support time and person time incidence rates correlated to UBRS. In a sub-analysis, single effects of UBRS variables on freedom from GIB were assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 111 CF-LVAD patients were included. The median UBRS was 2 (3\u20131). Receiver operating characteristic curve analysis showed an area under the curve of 0.519 (P = 0.758, 95% confidence interval = 0.422\u20130.615) at 3 years and an area under the curve of 0.515 (P = 0.797, 95% confidence interval = 0.418\u20130.611) during whole support time. No significant difference was observed in UBRS between bleeders and non-bleeders (P = 0.80). No significant difference in freedom from GIB was observed (P3 years = 0.7; Psupport-time = 0.816) and no independent significance regarding the freedom from bleeding at 3 years for any variable was observed. Coronary artery disease was associated with higher risk of GIB beyond the 3rd year (P = 0.048).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>UBRS was not able to predict GIB and therefore not applicable in our cohort of patients. Coronary artery disease could lead to a higher risk for GIB during support time. An additional validation in a larger cohort is advisable.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab572","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T20:11:22Z","timestamp":1639685482000},"source":"Crossref","is-referenced-by-count":5,"title":["An external validation study of the Utah Bleeding Risk Score"],"prefix":"10.1093","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3505-2444","authenticated-orcid":false,"given":"Armin","family":"Peivandi","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Muenster , Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henryk","family":"Welp","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Muenster , Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela","family":"Scherer","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Muenster , Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen R","family":"Sindermann","sequence":"additional","affiliation":[{"name":"Interdisciplinary Heart Failure Section, University Hospital Muenster , Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4610-6666","authenticated-orcid":false,"given":"Nana-Maria","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care and Pain Therapy, University Hospital Muenster , Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo M","family":"Dell\u2019Aquila","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Muenster , Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"key":"2022070609471711500_ezab572-B1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ehf2.12005","article-title":"Heart failure: preventing disease and death worldwide","volume":"1","author":"Ponikowski","year":"2014","journal-title":"ESC Heart Fail"},{"key":"2022070609471711500_ezab572-B2","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1002\/ejhf.1858","article-title":"Epidemiology of heart failure","volume":"22","author":"Groenewegen","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"2022070609471711500_ezab572-B3","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/eurjhf\/hfq121","article-title":"Epidemiology and clinical course of heart failure with preserved ejection fraction","volume":"13","author":"Lam","year":"2011","journal-title":"Eur J Heart Fail"},{"key":"2022070609471711500_ezab572-B4"},{"key":"2022070609471711500_ezab572-B5","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1056\/NEJMoa1800866","article-title":"Two-year outcomes with a magnetically levitated cardiac pump in heart failure","volume":"378","author":"Mehra","year":"2018","journal-title":"N Engl J Med"},{"key":"2022070609471711500_ezab572-B6","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.healun.2017.07.005","article-title":"Eighth annual INTERMACS report: special focus on framing the impact of adverse events","volume":"36","author":"Kirklin","year":"2017","journal-title":"J Heart Lung Transplant"},{"key":"2022070609471711500_ezab572-B7","doi-asserted-by":"crossref","first-page":"3945","DOI":"10.3748\/wjg.v23.i22.3945","article-title":"Bleeding with the artificial heart: gastrointestinal hemorrhage in CF-LVAD patients","volume":"23","author":"Gurvits","year":"2017","journal-title":"World J Gastroenterol"},{"key":"2022070609471711500_ezab572-B8","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.gie.2014.03.040","article-title":"GI bleeding in patients with continuous-flow left ventricular assist devices: a systematic review and meta-analysis","volume":"80","author":"Draper","year":"2014","journal-title":"Gastrointest Endosc"},{"key":"2022070609471711500_ezab572-B9","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/j.athoracsur.2015.03.010","article-title":"Hospital readmissions after continuous-flow left ventricular assist device implantation: incidence, causes, and cost analysis","volume":"100","author":"Akhter","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2022070609471711500_ezab572-B10","doi-asserted-by":"crossref","first-page":"24","DOI":"10.14797\/mdcj-11-1-24","article-title":"Gastrointestinal bleeding after continuous-flow left ventricular device implantation: review of pathophysiology and management","volume":"11","author":"Guha","year":"2015","journal-title":"Methodist Debakey Cardiovasc J"},{"key":"2022070609471711500_ezab572-B11","doi-asserted-by":"crossref","first-page":"e005267","DOI":"10.1161\/CIRCHEARTFAILURE.118.005267","article-title":"Novel model to predict gastrointestinal bleeding during left ventricular assist device support: the Utah Bleeding Risk Score","volume":"11","author":"Yin","year":"2018","journal-title":"Circ Heart Fail"},{"key":"2022070609471711500_ezab572-B12","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/MAT.0000000000000758","article-title":"Gastrointestinal bleeding in left ventricular assist device: octreotide and other treatment modalities","volume":"64","author":"Molina","year":"2018","journal-title":"ASAIO J"},{"key":"2022070609471711500_ezab572-B13","doi-asserted-by":"crossref","first-page":"e004638","DOI":"10.1161\/CIRCHEARTFAILURE.117.004638","article-title":"Clinical and in vitro evidence that left ventricular assist device-induced von Willebrand factor degradation alters angiogenesis","volume":"11","author":"Bartoli","year":"2018","journal-title":"Circ Heart Fail"},{"key":"2022070609471711500_ezab572-B14","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1007\/s10620-016-4123-4","article-title":"Gastrointestinal bleeding following LVAD placement from top to bottom","volume":"61","author":"Cushing","year":"2016","journal-title":"Dig Dis Sci"},{"key":"2022070609471711500_ezab572-B15","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.gie.2011.12.014","article-title":"Evaluation of GI bleeding after implantation of left ventricular assist device","volume":"75","author":"Kushnir","year":"2012","journal-title":"Gastrointest Endosc"},{"key":"2022070609471711500_ezab572-B16","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/MAT.0000000000001224","article-title":"Preoperative right heart dysfunction and gastrointestinal bleeding in patients with left ventricular assist devices","volume":"67","author":"Liebo","year":"2021","journal-title":"ASAIO J"},{"key":"2022070609471711500_ezab572-B17","doi-asserted-by":"crossref","first-page":"2550","DOI":"10.3748\/wjg.v26.i20.2550","article-title":"Treatment of gastrointestinal bleeding in left ventricular assist devices: a comprehensive review","volume":"26","author":"Vedachalam","year":"2020","journal-title":"World J Gastroenterol"},{"key":"2022070609471711500_ezab572-B18","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1038\/s41598-019-42334-3","article-title":"Functional capillary impairment in patients with ventricular assist devices","volume":"9","author":"Wadowski","year":"2019","journal-title":"Sci Rep"},{"key":"2022070609471711500_ezab572-B19","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.amjcard.2015.10.041","article-title":"Risk factors and outcomes of gastrointestinal bleeding in left ventricular assist device recipients","volume":"117","author":"Joy","year":"2016","journal-title":"Am J Cardiol"},{"key":"2022070609471711500_ezab572-B20","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1161\/CIRCHEARTFAILURE.112.000206","article-title":"Pulsatility and the risk of nonsurgical bleeding in patients supported with the continuous-flow left ventricular assist device HeartMate II","volume":"6","author":"Wever-Pinzon","year":"2013","journal-title":"Circ Heart Failure"},{"key":"2022070609471711500_ezab572-B21","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/MAT.0000000000000766","article-title":"Association of pulsatility with gastrointestinal bleeding in a cohort of heartmate II recipients","volume":"64","author":"Edwards","year":"2018","journal-title":"ASAIO J"},{"key":"2022070609471711500_ezab572-B22","doi-asserted-by":"crossref","first-page":"3697","DOI":"10.1007\/s10620-015-3743-4","article-title":"The incidence, predictors and outcomes of gastrointestinal bleeding in patients with left ventricular assist device (LVAD)","volume":"60","author":"Jabbar","year":"2015","journal-title":"Dig Dis Sci"},{"key":"2022070609471711500_ezab572-B23","article-title":"Effect of artificial pulse and pulsatility on gastrointestinal bleeding rates after left ventricular assist device implantation","volume":"68","author":"Hanke","year":"2020","journal-title":"Thorac Cardiovasc Surg"},{"key":"2022070609471711500_ezab572-B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13019-018-0703-z","article-title":"Is there a difference in bleeding after left ventricular assist device implant: centrifugal versus axial?","volume":"13","author":"Gaffey","year":"2018","journal-title":"J Cardiothorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/1\/ezab572\/44411781\/ezab572.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/1\/ezab572\/44411781\/ezab572.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T09:48:55Z","timestamp":1657100935000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezab572\/6506259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,13]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,6,15]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezab572","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,7,1]]},"published":{"date-parts":[[2022,1,13]]},"article-number":"ezab572"}}