Evidence map›Paper›PMID 34321851›Full record

ArticleWorld journal of gastroenterology2021

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

Sonali Palchaudhuri, Ishita Dhawan, Afshin Parsikia, Edo Y Birati, Joyce Wald, Shazia Mehmood Siddique, Laurel R Fisher

Open access · hybridAbstract read
In one paragraph

Article in World journal of gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Sonali PalchaudhuriDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA 19104, United States. sonali@post.harvard.edu.
Ishita DhawanDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA 19104, United States.
Afshin ParsikiaDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA 19104, United States.
Edo Y BiratiDivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.
Joyce WaldDivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.
Shazia Mehmood SiddiqueDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA 19104, United States.
Laurel R FisherDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA 19104, United States.
University of Pennsylvania · US

Funding

CLINICAL EPIDEMIOLOGY TRAINING IN GASTROENTEROLOGYT32DK007740 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI James D Lewis · 1997 to 2026
$9.2M
Evaluation of variability in care and outcomes for patients with gastrointestinal bleedingK08DK120902 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI SIDDIQUE, SHAZIA MEHMOOD · 2020 to 2024
$851k
NIDDK NIH HHS K08 DK120902NIDDK NIH HHS T32 DK007740
6 · The paper itself

Abstract

backgroundPatients with left ventricular assist devices (LVADs) are at increased risk for recurrent gastrointestinal bleeding (GIB) and repeat endoscopic procedures. We assessed the frequency of endoscopy for GIB in patients with LVADs and the impact of endoscopic intervention on preventing a subsequent GIB.

aimTo evaluate for an association between endoscopic intervention and subsequent GIB. Secondary aims were to assess the frequency of GIB in our cohort, describe GIB presentations and sources identified, and determine risk factors for recurrent GIB.

methodsWe 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 2019. We performed a descriptive analysis of the GIB burden and the outcome of endoscopic procedures performed. We performed multivariate logistic regression to evaluate the association between endoscopic intervention and subsequent GIB.

resultsIn the cohort of 295 patients, 97 (32.9%) had at least one GIB hospital encounter. There were 238 hospital encounters, with 55.4% (132/238) within the first year of LVAD implantation. GIB resolved on its own by discharge in 69.8% (164/235) encounters. Recurrent GIB occurred in 55.5% (54/97) of patients, accounting for 59.2% (141/238) of all encounters. Of 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,

conclusionPatients implanted with LVADs whom experience recurrent GIB frequently undergo repeat admissions and endoscopic procedures. In 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 population. A prospective study is needed to identify patients with LVAD at risk of recurrent GIB and determine more effective management strategies.

Indexed as

Heart-Assist DevicesHeart FailureEndoscopyGastrointestinal HemorrhageHumansRetrospective StudiesRisk FactorsEndoscopic intervention, Inpatient careGastrointestinal bleedingHospital readmissionsLeft ventricular-assist deviceRecurrent bleeding

Identifiers

PMID34321851
PMCPMC8291026
OpenAlexW3184751964

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.