K. Gore et al.: J Extra Corpor Technol 2026, 58, 39 – 42 41
findings support the importance of comorbidity assessment in risk stratification for MCS patients.
Limitations
This study has limitations inherent to a retrospective singlecenter design. Data completeness, though strengthened by electronic medical records, may be imperfect. Another limitation is the lack of device-type analysis. Our current sample size does not permit robust statistical comparisons between device types. However, all MCS devices share intravascular access to the systemic circulation, triggering inflammation and activation of the coagulation cascade – a mechanism particularly relevant in insulin-dependent diabetes. Future studies should prioritize device-specific analyses.
Conclusions
Insulin-dependent diabetes was associated with an increased risk for GI bleeding during MCS. Patients with this complication more often required major transfusions and experienced longer hospital stays. This suggests the need for further investigation into anticoagulation strategies. Knowledge derived from this analytical study may inform institutional protocols to improve outcomes in this population.
Funding The authors received no funding to complete this research.
Conflicts of interest The authors declare no conflict of interest.
Data availability statement All available data are incorporated into the article.
Author contribution statement
Kelsey Gore, BS, RRT: Design, Data harvest, Editorial review of the manuscript. Dean Linder, Jr., CCP, LP: Editorial review of the manuscript. Juan José Martinez Duque, MD: Data harvest, Editorial review of the manuscript. Junxi Wang BS: Data harvest, Editorial review of the manuscript. Connor Rudnicki DO: Editorial review of the manuscript. Shaun Yockelson, MD: Editorial review of the manuscript. Adrian Alexis Ruiz, MD: Editorial review of the manuscript. Bobby D. Nossaman, MD: Research Design, Statistics, Data harvest, Editorial review of the manuscript.
Ethics approval IRB approval 2023.201- MCS
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Cite this article as: Gore K, Linder D, Duque JJM, Wang J, Rudnicki C, Alexis Ruiz A, Yockelson S & Nossaman B. Incidence and pathophysiology of gastrointestinal bleeding during mechanical circulatory support: A retrospective analysis using machine learning algorithms. J Extra Corpor Technol 2026, 58, 39 – 42. https:// doi. org / 10.1051 / ject / 2025061.