Gastrointestinal Bleeding During Long-Term Left Ventricular Assist Device Support: External Validation of UTAH...

Area of Science:

• Cardiology
• Medical Devices
• Gastroenterology

Background:

• Gastrointestinal bleeding (GIB) is a frequent complication in patients with left ventricular assist device (LVAD) support.
• The UTAH bleeding risk score (UBRS) is the sole existing model for predicting GIB, but requires external validation.
• The predictive accuracy of other bleeding risk scores (ARC-HBR, HASBLED) in LVAD patients remains untested.

Purpose of the Study:

• To validate the UTAH bleeding risk score (UBRS) in a cohort of LVAD patients.
• To compare the predictive accuracy of UBRS against the ARC-HBR and HASBLED scores for bleeding events in LVAD patients.

Main Methods:

• Retrospective analysis of 75 consecutive patients undergoing LVAD implantation.
• Evaluation of major adverse events and bleeding events from 2010 to 2021.
• Assessment of score accuracy using Receiver Operating Characteristic (ROC) curve analysis.

Main Results:

• A high incidence of major adverse events (77.3%) and major bleeding (37.3%) was observed.
• Gastrointestinal bleeding constituted the majority of major bleeding events (43%).
• UBRS demonstrated strong discriminatory power (AUC=0.86), outperforming ARC-HBR (AUC=0.61) and HASBLED (AUC=0.52).

Conclusions:

• The UBRS was confirmed as an accurate tool for stratifying bleeding risk in LVAD patients.
• Gastrointestinal bleeding is a significant, life-threatening complication associated with VAD support, impacting patient survival and increasing re-hospitalization rates.