{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:37:29Z","timestamp":1769128649777,"version":"3.49.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Gastrointestinal bleeding (GIB) is a leading cause of morbidity during continuous-flow left ventricular assist device (CF-LVAD) support. GIB risk assessment could have important implications for candidate selection, informed consent, and postimplant therapeutic strategies. The aim of the study is to derive and validate a predictive model of GIB in CF-LVAD patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>CF-LVAD recipients at the Utah Transplantation Affiliated Hospitals program between 2004 and 2017 were included. GIB associated with a decrease in hemoglobin \u22652 g\/dL was the primary end point. A weighted score comprising preimplant variables independently associated with GIB was derived and internally validated. A total of 351 patients (median age, 59 years; 82% male) were included. After a median of 196 days, GIB occurred in 120 (34%) patients. Independent predictors of GIB included age &gt;54 years, history of previous bleeding, coronary artery disease, chronic kidney disease, severe right ventricular dysfunction, mean pulmonary artery pressure &lt;18 mm\u2009Hg, and fasting glucose &gt;107 mg\/dL. A weighted score termed Utah bleeding risk score, effectively stratified patients based on their probability of GIB: low (0\u20131 points) 4.8%, intermediate (2\u20134) 39.8%, and high risk (5\u20139) 83.8%. Discrimination was good in the development sample (c-index: 0.83) and after internal bootstrap validation (c-index: 0.74).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The novel Utah bleeding risk score is a simple tool that can provide personalized GIB risk estimates in CF-LVAD patients. This scoring system may assist clinicians and investigators in designing tailored risk-based strategies aimed at reducing the burden posed by GIB in the individual CF-LVAD patient and healthcare systems.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.118.005267","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T10:00:39Z","timestamp":1544522439000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":45,"title":["Novel Model to Predict Gastrointestinal Bleeding During Left Ventricular Assist Device Support"],"prefix":"10.1161","volume":"11","author":[{"given":"Michael Yaoyao","family":"Yin","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane","family":"Ruckel","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdallah G.","family":"Kfoury","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, UT (A.G.K., B.B.R.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen H.","family":"McKellar","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City (S.H.M., A.K., G.J.S., C.H.S.)"},{"name":"George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT (S.H.M., E.M.G., J.N.-N., J.S., J.C.F., S.G.D., C.H.S., O.W.-P.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iosif","family":"Taleb","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward M.","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"},{"name":"George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT (S.H.M., E.M.G., J.N.-N., J.S., J.C.F., S.G.D., C.H.S., O.W.-P.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Nativi-Nicolau","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"},{"name":"George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT (S.H.M., E.M.G., J.N.-N., J.S., J.C.F., S.G.D., C.H.S., O.W.-P.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josef","family":"Stehlik","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"},{"name":"George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT (S.H.M., E.M.G., J.N.-N., J.S., J.C.F., S.G.D., C.H.S., O.W.-P.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce B.","family":"Reid","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, UT (A.G.K., B.B.R.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antigone","family":"Koliopoulou","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City (S.H.M., A.K., G.J.S., C.H.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory J.","family":"Stoddard","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"},{"name":"Division of Cardiothoracic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City (S.H.M., A.K., G.J.S., C.H.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"Fang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavros G.","family":"Drakos","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (M.Y.Y., S.R., I.T., E.M.G., J.N.-N., J.S., G.J.S., J.C.F., S.G.D., O.W.-P.)"},{"name":"George E. 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