A creatinine-based model for predicting recurrent bleeding after modified percutaneous transhepatic variceal embolization in patients with cirrhosis

作     者：Kun Ji Xin Li Hanlong Zhu Si Zhao Pengchao Zhan Yang Shi Shuwen Ye Bingcan Xie Yuyuan Zhang Peng Yu Zhigang Ren Juan Ding Xinwei Han Zhen Li Kun Ji;Xin Li;Hanlong Zhu;Si Zhao;Pengchao Zhan;Yang Shi;Shuwen Ye;Bingcan Xie;Yuyuan Zhang;Peng Yu;Zhigang Ren;Juan Ding;Xinwei Han;Zhen Li

作者机构：Hepaobilary and Pancreatic Ientionod Treatment CenterDivston of Heptbiliay and Pancreatic SurgenyThe Pirst fliated HospitalZhejiang University School of MedicineHangzhouZhejiang ProvinceChina Deprtnent of Inteventional RadiologyThe First Aftlated Hospital of Zhengzhou UntversityZhengzhouHenan ProvinceChina Department of Gastroenterology and HpatologyJinling HopitalMedical School of Nanjing UneversiyNanjing210002Jiangsu ProvinceChina Deparment of Gastroenterologyfiliated Drum Tower Hospitadl of Nanying University Medical SchooNajin 210008Jiangsu ProvinceChina Department of Infecious DiseasesThe Frst Afilated Hosital of Zhengzhou UniversityZhengzhouHenan ProvinceChina Department of Qualiy ConurolThe Pirnt Afllated Hospital of Zhengzhou UnivesiyZhenghouHenarn ProwinceChina 

出 版 物：《Journal of Interventional Medicine》 (介入医学杂志（英文）)

年 卷 期：2022年第5卷第2期

页      面：95-102页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：the Key Scientific Research Project of Colleges and Universities in Henan Province China(grant number 17A320011) 

主　　题：Esophagogastric varices Percutaneous transhepatic variceal embolization Nomogram Prediction 

摘      要：Background:Patients who survive initial esophagogastric variceal bleeding(EVB)are at an increased risk of recurrent bleeding and death;however,a reliable predictive model is *** aimed to develop a model for rebleeding prediction in patients with EVB after modified percutaneous transhepatic variceal embolization(PTVE)with ***:A total of 122 patients with EVB who underwent PTVE from January 2015 to November 2020 were *** logistic analyses were conducted to determine independent risk factors for nomogram *** discrimination,calibration,and clinical utility of the nomogram were compared with the Model for End-stage Liver Disease score(MELD)and the Child–Pugh *** stratification was performed according to the ***:Rebleeding within 3 months of PTVE occurred in 32 patients(26.2%).Independent rebleeding indicators included prior history of endoscopic therapy,Child–Pugh score,partial splenic embolization,and creatinine *** nomogram incorporating these four predictors achieved excellent calibration and discriminatory abilities,with a concordance index of 0.85,which was confirmed to be 0.83 through bootstrapping *** nomogram demonstrated superior discrimination and clinical applicability than the MELD and Child–Pugh *** shown in the Kaplan–Meier curves,high-risk patients had a high probability of rebleeding(P0.001).Conclusions:The creatinine-based nomogram had a superior ability to predict rebleeding after PTVE in patients with *** stratification may help identify high-risk patients and lead to the earlier implementation of aggressive treatments and formulation of intensive follow-up plans.