ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1618626
This article is part of the Research TopicInnovative Modeling and Simulation in Thrombosis and Hemostasis: Enhancing Diagnosis and TreatmentView all articles
Analysis of influencing factors and construction of predictive model for major gastrointestinal bleeding after receiving VTE prophylactic anticoagulants in non-tumor patients
Provisionally accepted
- 1Baoding First Central Hospital, Baoding, China
- 2Baoding First Hospital, Baoding, China
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Objective: This study explored the factors associated with major gastrointestinal bleeding (MGB) after the use of prophylactic anticoagulants in patients with high risk of venous thromboembolism (VTE) and developed a predictive model to more accurately identify patients at high risk of MGB.We collected related data on patients with a high risk of VTE and a low risk of bleeding between January 2020 and December 2024. Propensity score matching (PSM) was conducted to balance the important factors related to the disease status between the non-MGB and MGB groups.By applying univariate and multivariable logistic regression, predictive factors were refined to construct the nomogram. The prediction accuracy of the model was assessed through bootstrapping method (1000 bootstrap samples), Hosmer-Lemeshow test, and calibration curve analysis. Decision curve analysis (DCA) was also used to assess the clinical applicability of the model.In total, 1,206 eligible patients (1,060 non-MGB vs. 146 MGB) were included. After PSM, the non-MGB group (n = 146) and the MGB group (n = 146) were more balanced in baseline variables. The results of the multivariable analysis showed that hemoglobin level (OR = 0.883, 95% CI: 0.855-0.911, P < 0.001), albumin level (OR = 0.834, 95%CI: 0.754-0.922, P < 0.001) and use of proton-pump inhibitors (PPIs) or H 2 -receptor antagonists (H 2 RAs) (OR = 0.375, 95%CI: 0.167-0.843, P = 0.018) were associated with a reduced risk of MGB. The congruence of the model's predictions with actual findings was confirmed by the calibration curve. Furthermore, DCA affirmed the clinical value of the model in predicting MGB.The addition of anemia and hypoproteinemia to the Improve-Bleed risk assessment model may help the timely and accurate screening of patients at high risk of MGB. The use of PPIs or H 2 RAs was associated with a reduced risk of MGB in patients receiving prophylactic anticoagulants for VTE.
Keywords: Padua risk assessment model, Improve-bleed risk assessment model, Venous Thromboembolism, major gastrointestinal bleeding, Prediction model
Received: 26 Apr 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Fu, Ren, Yang, Niu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoxue Fu, Baoding First Central Hospital, Baoding, China
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