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A dynamic online nomogram for predicts delayed postoperative bleeding after colorectal polyp surgery.

Liting Xu1,2,3, Na Zhang1,2,3, Yongxia Zhang1,2,3

  • 1The First Clinical Medicine, Lanzhou University, Lanzhou, 730000, Gansu, China.

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|August 25, 2024
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Summary

Identifying patients at risk for delayed postoperative bleeding (DPPB) after colorectal polyp surgery is crucial. This study developed a dynamic nomogram using risk factors like direct oral anticoagulants and polyp location to predict DPPB.

Keywords:
DPPBDynamic online nomogramPrediction modelRisk factors

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Medical Informatics

Background:

  • Delayed postoperative bleeding (DPPB) is a significant complication following colorectal polyp surgery.
  • Accurate risk stratification is essential for patient management and preventing adverse outcomes.

Purpose of the Study:

  • To identify independent risk factors for DPPB after endoscopic colorectal polypectomy.
  • To develop and validate a dynamic nomogram for predicting DPPB risk.
  • To provide clinicians with a tool for personalized patient care.

Main Methods:

  • Retrospective analysis of 1544 patients undergoing endoscopic colorectal polypectomy.
  • Univariate analysis, LASSO, and logistic regression to identify risk factors.
  • Construction and validation of a dynamic nomogram using ROC curves, calibration plots, and DCA.

Main Results:

  • DPPB occurred in 38 patients (2.46%).
  • Independent risk factors identified: direct oral anticoagulants (DOACs), right colon polyp location, larger polyp diameter, alcohol consumption, and prophylactic hemoclips.
  • The dynamic nomogram demonstrated high predictive accuracy (AUC 0.936 training, 0.796 validation, 0.865 full set) and clinical utility.

Conclusions:

  • The developed dynamic nomogram effectively predicts DPPB risk in patients undergoing colorectal polyp surgery.
  • The nomogram facilitates early identification of high-risk individuals, enabling tailored interventions.
  • Clinical application of this tool can improve patient safety and outcomes in colorectal polypectomy.