{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T06:19:33Z","timestamp":1792995573699,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,28]],"date-time":"2017-12-28T00:00:00Z","timestamp":1514419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","award":["29\u20102001"],"award-info":[{"award-number":["29\u20102001"]}],"id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","award":["26A\u2010201"],"award-info":[{"award-number":["26A\u2010201"]}],"id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The study developed a predictive model of long\u2010term gastrointestinal (GI) bleeding risk in patients receiving oral anticoagulants and compared it with the HAS\u2010BLED (Hypertension, Abnormal renal\/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratios, Elderly, Drugs\/alcohol concomitantly) score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study periodically followed a cohort of 508 patients taking oral anticoagulants (66 direct oral anticoagulants users and 442 warfarin users). Absence of GI bleeding at an initial examination and any subsequent GI bleeding were confirmed endoscopically. The bleeding model was developed by multivariate survival analysis and evaluated by Harrell's c\u2010index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a median follow\u2010up of 31.4\u00a0months, 42 GI bleeds (8.3%) occurred: 42.8% in the upper GI tract, 50.0% in the lower GI tract, and 7.1% in the middle GI tract. The cumulative 5 and 10\u2010year probability of GI bleeding was 12.6% and 18.5%, respectively. Patients who bled had a significantly higher cumulative incidence of all\u2010cause mortality (hazard ratio 2.9, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Multivariate analysis revealed that absence of proton pump inhibitor therapy, chronic kidney disease, chronic obstructive pulmonary disease, history of peptic ulcer disease, and liver cirrhosis predicted GI bleeding. The c\u2010statistic for the new predictive model using these five factors was 0.65 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), higher than the HAS\u2010BLED score of 0.57 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.145).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gastrointestinal bleeding increased the risk of subsequent mortality during follow\u2010up of anticoagulated patients, highlighting the importance of prevention. The study developed a new scoring model for acute GI bleeding risk based on five factors (no\u2010proton pump inhibitor use, chronic kidney disease, chronic obstructive pulmonary disease, history of peptic ulcer disease, and liver cirrhosis), which was superior to the HAS\u2010BLED score.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13830","type":"journal-article","created":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T20:48:08Z","timestamp":1495572488000},"page":"164-171","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["New predictive model for acute gastrointestinal bleeding in patients taking oral anticoagulants: A cohort study"],"prefix":"10.1111","volume":"33","author":[{"given":"Akira","family":"Shimomura","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyoshi","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuro","family":"Shimbo","sequence":"additional","affiliation":[{"name":"Clinical Research and Informatics Ohta Nishinouchi Hospital  Koriyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiori","family":"Moriyasu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Okubo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chizu","family":"Yokoi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology National Center for Global Health and Medicine, Kohnodai Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.121218"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.13.1414"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2012.07.012"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107039"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.06.023"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.687"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"E148","DOI":"10.1055\/s-0034-1377287","article-title":"Supratherapeutic anticoagulation at presentation is associated with reduced mortality in nonvariceal upper gastrointestinal hemorrhage","volume":"2","author":"Irwin J","year":"2014","journal-title":"Endosc. 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