[Outcomes of Endoscopic Treatment of Esophagogastric Variceal Bleeding and Construction and Validation of a 1-Year Rebleeding Risk Prediction Model].

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Tác giả: Yuanjing He, Xiaomei Huang, Yujun Luo, Jianbo Yang, Lili Zhang

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: China : Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 724412

 OBJECTIVE: To explore the efficacy of endoscopic therapy for esophageal and gastric variceal bleeding (EGVB), investigate the risk factors for rebleeding within 1 year, and establish a predictive model accordingly. METHODS: A retrospective study was conducted using the clinical and follow-up data of 120 EGVB patients who underwent endoscopy at our hospital between January 2021 and December 2022. The efficacy of endoscopic therapy was analyzed, and the patients were divided into a bleeding group and a non-bleeding group based on whether rebleeding occurred within 1 year after treatment. The factors influencing rebleeding within 1 year after treatment were analyzed, and a predictive model was established using logistic regression analysis. The model's goodness of fit was evaluated using the Hosmer-Lemeshow test, and its clinical value was analyzed using the receiver operating characteristic (ROC) curve. RESULTS: The hemostasis success rate within 72 hours after endoscopic therapy was 100% in all 120 patients. Four weeks after endoscopic treatment, endoscopic reexamination showed that the complete and partial disappearance rate of varices was 75.83% (91/120), with rebleeding occurring in 10 cases (8.33%). There were 34 cases (28.33%) of cumulative rebleeding at 6 months and 63 cases (52.50%) at 1 year after endoscopic therapy. Nine patients (7.50%) died within 1 year after endoscopic therapy, all of whom were rebleeding cases. A total of 63 patients with rebleeding were included in the bleeding group, and 57 patients without rebleeding were included in the non-bleeding group. Serum sodium <
  135 mmol/L (odds ratio [OR] = 3.837, 95% confidence interval [CI]: 1.095-13.445), Child-Pugh grade C (OR = 3.835, 95% CI: 1.137-12.935), esophageal varices degree G3 (OR = 5.113, 95% CI: 1.565-16.707), and main portal vein diameter >
  12 mm (OR = 5.964, 95% CI: 2.295-15.497) were identified as risk factors of rebleeding within 1 year after endoscopic therapy in EGVB patients ( CONCLUSION: Endoscopic therapy for EGVB achieves a high rate of acute bleeding control, but patients remain at risk of rebleeding. Rebleeding is associated with serum sodium <
  135 mmol/L, Child-Pugh grade C, main portal vein diameter >
  12 mm, and esophageal varices degree G3. The logistic regression model can effectively predict the probability of rebleeding within 1 year after endoscopic therapy.
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