Construction of A Risk Prediction Model for Rebleeding in EVB Patients with Liver Cirrhosis after Endoscopic Treatment
DING Jing
ZHU Hong
CHEN Li
CHEN Xi
ZHANG Daoquan
ZHU Zhenghui
YANG Yanqing
Abstract：Objective To investigate the risk factors for rebleeding after endoscopic treatment in patients with cir-rhotic esophagogastric variceal bleeding(EVB)and to construct a risk prediction model.Methods A total of 206 cirrhotic EVB patients who received endoscopic treatment at the First Affiliated Hospital of Nanjing Medical University from January 2023 to October 2024 were enrolled.After 6 months of follow-up,they were divided into a rebleeding group(49 cases)and a non-rebleeding group(157 cases).General clinical data were compared between groups.Multivariate Logistic stepwise re-gression analysis was used to identify influencing factors for rebleeding after endoscopic treatment,and a nomogram model was constructed and validated.Results The rebleeding group showed higher rates of Child-Pugh grade C,presence of red color signs,larger diameters of variceal veins,portal veins,and splenic veins compared to the non-rebleeding group,hemo-globin,platelet count,serum sodium,and albumin levels were lower in the rebleeding group(P<0.05).Multivariate Logistic stepwise regression analysis identified Child-Pugh grade C(OR=2.356,95%CI:1.598-3.473),red color signs(OR=2.158,95%CI:1.501-3.101),variceal vein diameter≥5.46 mm(OR=2.489,95%CI:1.656-3.742),and portal vein diameter≥13.17 mm(OR=2.729,95%CI:1.798-4.143)as risk factors for rebleeding(all P<0.001),and serum sodium was a protective factor(OR=0.442,95%CI:0.301-0.649,P<0.001).The nomogram model achieved an AUC of 0.902(95%CI:0.849-0.955)for pre-dicting rebleeding,with 68.47%specificity and 92.05%sensitivity.Conclusion Child-Pugh grading,red color signs,vari-ceal vein diameter,portal vein diameter,and serum sodium influence rebleeding after initial endoscopic treatment in cirrhotic EVB patients.The constructed nomogram model demonstrates high predictive value for rebleeding.
Keywords：Liver cirrhosisEsophageal and gastric varicesRebleedingNomogram
Publication Date：2025-07-20
Online Publishing Date：2025-08-27(First online date of this platform, not the publication date of the document)
Pages：6( 84-89 )