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Risk factors and prediction model for rebleeding in grade IIb peptic ulcer patients after endoscopy
Fei Wang1, Guangxi Qi2, Xue Guan1
1Department of Gastroenterology, Beijing Pinggu Hospital Beijing 101200, China.
Objective:
To investigate the risk factors for rebleeding in patients with IIb peptic ulcer bleeding (PUB) treated endoscopically and to develop a nomogram model.
Method:
A retrospective analysis was conducted on 287 patients with grade IIb PUB who underwent endoscopic treatment at Beijing Pinggu Hospital from January 2019 to December 2023. The patients were divided into a modelling cohort (n=201) and a validation cohort (n=86) in a 7:3 ratio. The modelling cohort consisted of a non-bleeding (NB) group (n=176) and a re-bleeding (RB) group (n=25), while the validation cohort included an NB group (n=75) and an RB group (n=11). Logistic regression was used to analyze and identify the risk factors for rebleeding after endoscopic treatment in class IIb PUB patients. Based on the results of Logistic regression, a nomogram model was developed, and receiver operating characteristic (ROC) curve and calibration curve were performed to evaluate its accuracy.
Results:
Ulcer site, ulcer diameter, Helicobacter pylori (Hp) infection, D-dimer (D-D), prothrombin time (PT), albumin (ALB), and prostaglandin E2 (PGE2) were associated with rebleeding after endoscopic treatment in grade IIb PUB patients (all P<0.05). Logistic regression analysis identified Hp infection (OR=9.723, P=0.007), D-D (OR=1.013, P=0.047), PT (OR=2.242, P=0.013), ALB (OR=0.899, P=0.036), and PGE2 (OR=0.987, P=0.042) as independent risk factors for rebleeding. The area under the ROC curve for the nomogram model constructed based on these factors was 0.875 (95% CI: 0.788-0.962).
Conclusion:
This study successfully identified key independent risk factors for rebleeding after endoscopic treatment in grade IIb PUB patients, providing clinicians with a scientific decision-making tool to reduce rebleeding risk and improve treatment outcomes.
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