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

引用

Journal of Interventional Medicine 2022年第2期5卷 95-102页

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 Hepaobilary and Pancreatic Ientionod Treatment Center Divston of Heptbiliay and Pancreatic SurgenyThe Pirst fliated HospitalZhejiang University School of MedicineHangzhouZhejiang ProvinceChina deprtnent of inteventional radiology The First Aftlated Hospital of Zhengzhou UntversityZhengzhouHenan ProvinceChina Department of Gastroenterology and Hpatology Jinling HopitalMedical School of Nanjing UneversiyNanjing210002Jiangsu ProvinceChina Deparment of Gastroenterology filiated Drum Tower Hospitadl of Nanying University Medical SchooNajin 210008Jiangsu ProvinceChina Department of Infecious Diseases The Frst Afilated Hosital of Zhengzhou UniversityZhengzhouHenan ProvinceChina Department of Qualiy Conurol The Pirnt Afllated Hospital of Zhengzhou UnivesiyZhenghouHenarn ProwinceChina

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(P<0.001).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.

关键词： Esophagogastric varices Percutaneous transhepatic variceal embolization Nomogram Prediction

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