Risk Prediction for Delayed Bleeding After Endoscopic Submucosal Dissection in Colorectal Precancerous Lesions Using...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Delayed bleeding is a significant complication following endoscopic submucosal dissection (ESD).
• Identifying patients at high risk for this complication is crucial for effective management.

Purpose of the Study:

• To identify risk factors for delayed bleeding after ESD in patients with colorectal precancerous lesions.
• To develop a predictive model for delayed bleeding post-ESD.

Main Methods:

• Retrospective, multicenter case-control study involving 956 patients.
• Utilized univariate and multivariate analyses to identify independent risk factors.
• Developed an XGBoost model for risk stratification.

Main Results:

• 7.5% of patients experienced delayed bleeding post-ESD.
• Independent risk factors identified: male gender, age ≥ 65, lesion size ≥ 30 mm, procedure time ≥ 120 minutes, rectal location.
• The XGBoost model differentiated low-risk (4.0% bleeding) and high-risk (13.1% bleeding) groups.

Conclusions:

• An XGBoost-based risk prediction model accurately forecasts delayed bleeding risk after colorectal ESD.
• The model aids in stratifying patients into low and high-risk categories for better clinical decision-making.