Predictors of gastrointestinal bleeding in patients following left ventricular assist device implantation: a systematic review and meta-analysis

Aim: Our study aims to provide a more holistic understanding of the available data and predictive risk factors for gastrointestinal bleed (GIB). Materials & methods: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Web of Science Core Collection and calculated relative risk and meta-regression was utilized to evaluate for risk factors in order to assess the effect of covariates. Results: Our meta-analysis reported a pooled prevalence rate of GIB of 24.4%. Meta-regression analysis did not yield a statistically significant association between GIB and risk factors, including age, gender, hypertension, chronic kidney disease and diabetes. Conclusion: Studies investigating larger sample sizes are required for conclusive findings. Plain language summary: Left ventricular assist devices are used for the circulation of blood throughout the body in cases where the left ventricle is not able to do so. After such a device is implanted, gastrointestinal (GI) bleeding has been reported which raises serious concerns for complications. Our study found that 24.4% of the total population reported GI bleed after implantation and that there is no significant association of GI bleed with the patient's age, gender and being diagnosed with diabetes mellitus, hypertension or chronic kidney disease. Non association of these conditions with GI bleed requires further investigation in the form of larger patient data for conclusive findings.