Evidence map›Paper›PMID 41382183›Full record

ArticleEuropean journal of medical research2025

A predictive nomogram for hemorrhage risk following endoscopic submucosal dissection of gastrointestinal tumors: a retrospective cohort study.

Fang Yang, Lanfang Zhang, Lu Yang, Yanli Zhu, Daiyuan Dong, Yongsheng Chang

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Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

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1 · What the graph read from it

What it found

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Fang YangThe Second Ward of Gastroenterology, The First Affiliated Hospital of Henan Medical University, No. 88, Health Road, Weihui, Xinxiang, 453100, Henan, China. fangy20101023@126.com.
Lanfang ZhangThe Second Ward of Gastroenterology, The First Affiliated Hospital of Henan Medical University, No. 88, Health Road, Weihui, Xinxiang, 453100, Henan, China.
Lu YangThe Second Ward of Gastroenterology, The First Affiliated Hospital of Henan Medical University, No. 88, Health Road, Weihui, Xinxiang, 453100, Henan, China.
Yanli ZhuThe Second Ward of Gastroenterology, The First Affiliated Hospital of Henan Medical University, No. 88, Health Road, Weihui, Xinxiang, 453100, Henan, China.
Daiyuan DongThe Second Ward of Gastroenterology, The First Affiliated Hospital of Henan Medical University, No. 88, Health Road, Weihui, Xinxiang, 453100, Henan, China.
Yongsheng ChangThe Second Ward of Gastroenterology, The First Affiliated Hospital of Henan Medical University, No. 88, Health Road, Weihui, Xinxiang, 453100, Henan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo develop a nomogram-based risk prediction model utilizing patients' clinical characteristics for post-endoscopic submucosal dissection hemorrhage, and to evaluate its clinical utility.

methodsA total of 250 patients who developed postprocedural hemorrhage after endoscopic submucosal dissection (ESD) for gastrointestinal tumors at our institution (2022-2024) were enrolled. Enrichment criteria included at least one high-risk factor for complications (e.g., lesion size > 10 mm, antithrombotic medication use, or comorbid diabetes/hypertension) or early post-ESD symptoms suggestive of complications. Patients were randomly divided into a training set (n = 175) and a validation set (n = 75) at a 7:3 ratio. In the training set, multivariate logistic regression identified independent prognostic risk factors to construct the nomogram. Model performance was assessed via receiver operating characteristic (ROC) curves and calibration plots, with external validation performed in the validation set.

resultsHemorrhage occurred in 70/175 cases (40.00%) in the training set and 28/75 (37.33%) in the validation set, with no statistically significant intergroup differences in incidence or baseline characteristics (P > 0.05). Univariate analysis revealed significant disparities between hemorrhage and non-hemorrhage groups in age, hemoglobin, white blood cell count, platelet count, prothrombin time, activated partial thromboplastin time, and fibrinogen (P < 0.05). Multivariate analysis confirmed age, hemoglobin, white blood cell count, platelet count, prothrombin time, activated partial thromboplastin time, and fibrinogen were independent risk factors (P < 0.05). The nomogram demonstrated C-index were 0.861 and 0.841 (validation), and mean absolute errors were 0.151 and 0.171, respectively. AUC values were 0.849 (95% CI 0.778-0.920) and 0.824 (95% CI 0.707-0.941), indicating high predictive accuracy.

conclusionsThe clinical feature-based nomogram exhibits good predictive performance and reliability in both training and validation cohorts, serving as a valuable tool for prognostic evaluation in gastrointestinal tumor patients who experience post-ESD hemorrhage.

Indexed as

Endoscopic Mucosal ResectionGastrointestinal HemorrhageGastrointestinal NeoplasmsNomogramsPostoperative HemorrhageAgedFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk AssessmentRisk FactorsROC CurveClinical characteristicsGastrointestinal neoplasmsNomogramTherapeutic prognosis

Identifiers

PMID41382183
PMCPMC12801423

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.