ArticleWorld journal of gastroenterology2025
Risk factors with nomogram construction for moderate to severe pain after endoscopic full-thickness resection.
Article in World journal of gastroenterology, 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
backgroundEndoscopic full-thickness resection (EFTR) is an effective treatment for gastrointestinal lesions. Compared with endoscopic submucosal dissection, EFTR is associated with a higher incidence of postoperative pain, particularly moderate to severe pain, which can significantly impact patients' quality of life and recovery. Although some studies have focused on postoperative analgesia, clinical evidence regarding the underlying mechanisms and risk factors of pain after EFTR - especially moderate to severe pain following upper gastrointestinal EFTR - remains limited.
aimTo identify risk factors for moderate to severe pain following EFTR and to construct a predictive nomogram for clinical use.
methodsWe conducted a retrospective analysis of patients who underwent EFTR at our center between October 1, 2019, and June 1, 2025. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with postoperative moderate to severe pain following EFTR. A nomogram was subsequently constructed based on a multivariate logistic regression model to predict the risk of moderate to severe pain following EFTR. The discrimination and calibration of the nomogram were evaluated by estimating the area under the receiver operator characteristic curve and by bootstrap resampling and visual inspection of the calibration curve. The clinical utility of the nomogram was assessed using decision curve analysis.
resultsA total of 172 patients who underwent EFTR were included in the study, of whom 27 (15.7%) experienced moderate to severe postoperative pain. Based on multivariate logistic regression analysis, higher body mass index was significantly associated with a reduced risk of moderate to severe postoperative pain [odds ratio (OR) = 0.83, 95% confidence interval (CI): 0.72-0.95,
conclusionIn this study, we successfully developed a predictive nomogram for identifying the risk of moderate to severe pain following EFTR surgery.
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