Yin et al reported the Utah Bleeding Risk Score to predict gastrointestinal bleeding for a patient with a left ventricular assist device (LVAD). This can help to identify a patient who may benefit from more aggressive or alternative management. The authors are from the University of Utah and Intermountain Medical Center in Salt Lake City.
Patient selection: left ventricular assist device, with anticoagulation and/or antiplatelet agents
Outcome: gastrointestinal bleeding
Parameters:
(1) age in years
(2) history of previous bleeding
(3) coronary artery disease (CAD)
(4) chronic kidney disease (CKD), unspecified eGFR
(5) severe right ventricular dysfunction
(6) mean pulmonary artery pressure in mm Hg (mean PAP)
(7) blood glucose in mg/dL, presumably fasting
|
Parameter
|
Finding
|
Points
|
|
age in year
|
<= 54 years of age
|
0
|
|
|
> 54 years of age
|
1
|
|
history of previous bleeding
|
no
|
0
|
|
|
yes
|
2
|
|
coronary artery disease
|
no
|
0
|
|
|
yes
|
1
|
|
chronic kidney disease
|
no
|
0
|
|
|
yes
|
1
|
|
severe right ventricular dysfunction
|
no
|
0
|
|
|
yes
|
1
|
|
mean PAP
|
< 18 mm Hg
|
2
|
|
|
>= 18 mm Hg
|
0
|
|
blood glucose
|
<= 107 mg/dL
|
0
|
|
|
> 107 mg/dL
|
1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
|
Total Score
|
Risk Category
|
3-Year GI Bleeding Risk
|
|
0 or 1
|
low
|
5%
|
|
2 to 4
|
intermediate
|
40%
|
|
5 to 9
|
high
|
84%
|
Performance:
• The area under the ROC curve is 0.74.
