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Does endoscopic intervention prevent subsequent gastrointestinal bleeding in patients with left ventricular assist devices?A retrospective study

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World Journal of Gastroenterology 2021年第25期27卷 3877-3887页

作者： Sonali Palchaudhuri Ishita Dhawan Afshin Parsikia Edo Y Birati Joyce Wald shazia mehmood siddique Laurel R Fisher Division of Gastroenterology and Hepatology University of PennsylvaniaPhiladelphiaPA 19104United States Division of Cardiovascular Medicine University of PennsylvaniaPhiladelphiaPA 19104United States

BACKGROUND Patients with left ventricular assist devices(LVADs)are at increased risk for recurrent gastrointestinal bleeding(GIB)and repeat endoscopic *** assessed the frequency of endoscopy for GIB in patients with LVADs and the impact of endoscopic intervention on preventing a subsequent *** To evaluate for an association between endoscopic intervention and subsequent *** aims were to assess the frequency of GIB in our cohort,describe GIB presentations and sources identified,and determine risk factors for recurrent *** We conducted a retrospective cohort study of all patients at a large academic institution who underwent LVAD implantation from January 2011–December 2018 and assessed all hospital encounters for GIB through December *** performed a descriptive analysis of the GIB burden and the outcome of endoscopic procedures *** performed multivariate logistic regression to evaluate the association between endoscopic intervention and subsequent *** In the cohort of 295 patients,97(32.9%)had at least one GIB hospital *** were 238 hospital encounters,with 55.4%(132/238)within the first year of LVAD *** resolved on its own by discharge in 69.8%(164/235)*** GIB occurred in 55.5%(54/97)of patients,accounting for 59.2%(141/238)of all *** the 85.7%(204/238)of encounters that included at least one endoscopic evaluation,an endoscopic intervention was performed in 34.8%(71/204).The adjusted odds ratio for subsequent GIB if an endoscopic intervention was performed during a GIB encounter was not significant(odds ratio 1.18,P=0.58).CONCLUSION Patients implanted with LVADs whom experience recurrent GIB frequently undergo repeat admissions and endoscopic *** this retrospective cohort study,adherence to endoscopic guidelines for performing endoscopic interventions did not significantly decrease the odds of subsequent GIB,thus suggesting the uniqueness of the LVAD pop

关键词： Gastrointestinal bleeding Left ventricular-assist device Endoscopic intervention,Inpatient care Hospital readmissions Recurrent bleeding

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