ArticleSichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition2025
[Outcomes of Endoscopic Treatment of Esophagogastric Variceal Bleeding and Construction and Validation of a 1-Year Rebleeding Risk Prediction Model].
Article in Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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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