{
    "abstract": "Left ventricular assist devices (LVADs) are indicated for patients with end-stage heart failure and require systemic anticoagulation. Gastrointestinal (GI) bleeding is a major adverse event following LVAD implantation. There is paucity of data on healthcare resource utilization in patients with LVAD and the risk factors of associated bleeding, despite the increase in GI bleeding. We investigated the in-hospital outcomes of GI bleeding in patients with continuous-flow (CF) LVAD.\nThis was a serial cross-sectional study of the Nationwide Inpatient Sample (NIS) in the CF-LVAD era from 2008-2017. All adults admitted to hospital with a primary diagnosis of GI bleeding were included. GI bleeding was diagnosed by ICD-9/ICD-10 codes. Patients with CF-LVAD (cases) and without CF-LVAD (controls) were compared using univariate and multivariate analyses.\nA total of 3,107,471 patients were discharged with a primary diagnosis of GI bleeding during the study period. Of these, 6569 (0.21%) had CF-LVAD-related GI bleeding. Overall, bleeding angiodysplasia accounted for the majority (69%) of LVAD-related GI bleeding. There was no statistical difference in mortality, but the length of hospital stay increased by 2.53 days (95% confidence interval [CI] 1.78-2.98; P<0.001) and the mean hospital charge per stay increased by $25,980 (95%CI 21,267-29,874; P<0.001) in 2017 compared to 2008. The results were consistent after propensity score matching.\nOur study highlights that patients with LVAD admitted to the hospital for GI bleeding experience longer hospital stays and greater healthcare costs that warrant risk-based patient evaluation and careful implementation of management strategies.",
    "authors": [
        {
            "affiliation": "Division of Gastroenterology, OSF Healthcare system, Saint Francis Medical Center, Peoria, IL, USA (Ishaan Vohra).",
            "firstname": "Ishaan",
            "initials": "I",
            "lastname": "Vohra"
        },
        {
            "affiliation": "Division of Gastroenterology and Hepatology, Department of Medicine, Cook County Health and Hospital System, County, Chicago, IL, USA (Hemant Mutneja).",
            "firstname": "Hemant",
            "initials": "H",
            "lastname": "Mutneja"
        },
        {
            "affiliation": "Division of Hematology and Oncology, Department of Medicine, University of Louisville, Louisville, KY, USA (Vatsala Katiyar).",
            "firstname": "Vatsala",
            "initials": "V",
            "lastname": "Katiyar"
        },
        {
            "affiliation": "Gastroenterology & Hepatology, University of Utah Health, Salt Lake City, UT, USA (Babu P. Mohan).",
            "firstname": "Babu P",
            "initials": "BP",
            "lastname": "Mohan"
        },
        {
            "affiliation": "Director, Center for Advanced Therapeutic Endoscopy (CATE) at Centura Health-Porter Adventist Hospital, Denver, Colorado, USA (Douglas Adler).",
            "firstname": "Douglas",
            "initials": "D",
            "lastname": "Adler"
        }
    ],
    "conclusions": "Our study highlights that patients with LVAD admitted to the hospital for GI bleeding experience longer hospital stays and greater healthcare costs that warrant risk-based patient evaluation and careful implementation of management strategies.",
    "copyrights": "Copyright: \u00a9 Hellenic Society of Gastroenterology.",
    "doi": "10.20524/aog.2023.0773",
    "journal": "Annals of gastroenterology",
    "keywords": [
        "Endoscopy",
        "angiodysplasia",
        "gastrointestinal bleeding",
        "heart failure",
        "left ventricular assist devices"
    ],
    "methods": null,
    "publication_date": "2023-03-04",
    "pubmed_id": "36864936\n17761592\n19920051\n30943783\n28942782\n19766801\n25452907\n22541185\n28705865\n1607900\n24858705\n23290542\n23915585\n18282712\n19817991\n19303790\n22086831\n20598466\n27017225\n27510753\n17532964\n24021944\n27908518\n24975405\n30571195\n29655662\n30883052\n27858326",
    "results": "A total of 3,107,471 patients were discharged with a primary diagnosis of GI bleeding during the study period. Of these, 6569 (0.21%) had CF-LVAD-related GI bleeding. Overall, bleeding angiodysplasia accounted for the majority (69%) of LVAD-related GI bleeding. There was no statistical difference in mortality, but the length of hospital stay increased by 2.53 days (95% confidence interval [CI] 1.78-2.98; P<0.001) and the mean hospital charge per stay increased by $25,980 (95%CI 21,267-29,874; P<0.001) in 2017 compared to 2008. The results were consistent after propensity score matching.",
    "title": "Temporal trends and risk factors of gastrointestinal bleeding in patients with left ventricular assist devices: a nationwide analysis 2008-2017.",
    "xml": "<Element 'PubmedArticle' at 0x788502e9f1f0>"
}