Risk Factors Analysis and Nomogram Model Development for Intrauterine Adhesions Following Endometrial Polypectomy
ZHAO Xiaochen
ZHANG Xiang
ZHAO Haochen
PANG Xuecheng
GAO Wenying
Abstract：Objective To analyze the risk factors for intrauterine adhesions after endometrial polyp(EP)surgery and to construct a nomogram model.Methods A total of 206 patients with EP who underwent hysteroscopic polypectomy at Cangzhou Central Hospital from April 2022 to March 2024 were included in this study.They were followed up continuously for one year postoperatively and divided into an intrauterine adhesion group(39 cases)and a non-intrauterine adhesion group(167 cases)based on the occurrence of intrauterine adhesions.Multivariate logistic stepwise regression analysis was used to identify the influencing factors for postoperative intrauterine adhesions in EP patients.A nomogram model was constructed to predict postoperative intrauterine adhesions in EP patients,and its predictive value was evaluated using the receiver operating characteristic curve.Results The intrauterine adhesion group had higher proportions of patients with gravidity≥2,disease duration≥3 years,polyp type(multiple),polyp diameter≥1 cm,history of curettage,and presence of an intrauterine device compared to the non-intrauterine adhesion group.The operation time was also longer in the intrauterine adhesion group(P<0.05).Multivariate analysis showed that polyp type(multiple)(OR=2.735,95%CI:1.773-4.217),history of curettage(OR=2.578,95%CI:1.688-3.937),presence of an intrauterine device(OR=2.206,95%CI:1.514-3.213),and longer operation time(OR=2.277,95%CI:1.554-3.337)were risk factors for postoperative intrauterine adhesions in EP patients(P<0.05).The area under the curve(95%CI)of the nomogram model for predicting postoperative intrauterine adhesions was 0.903(0.852-0.954),with a specificity of 67.91%and a sensitivity of 92.46%.Conclusion The nomogram model constructed based on risk factors for postoperative intrauterine adhesions in EP patients demonstrates good predictive performance and can be used to guide individualized clinical risk assessment.
Keywords：endometrial polypintrauterine adhesionsrisk factorsnomogram
Publication Date：2025-11-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：5( 103-107 )