Establishment of a Nomogram model for individualized prediction of the risk of delayed bleeding after endoscopic submucosal dissection for early gastrointestinal tumors
10.3760/cma.j.cn115682-20200515-03365
- VernacularTitle:个体化预测早期消化道肿瘤ESD术后迟发性出血风险的列线图模型的建立
- Author:
Guifeng YANG
1
;
Minya YU
;
Xuelan YANG
Author Information
1. 江苏省泰州市人民医院消化内科 225300
- Keywords:
Digestive system neoplasms;
Nomogram;
Endoscopic submucosal dissection;
Delayed bleeding;
Nursing strategy
- From:
Chinese Journal of Modern Nursing
2021;27(2):164-170
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore risk factors of individually predicting delayed bleeding after endoscopic submucosal dissection (ESD) for patients with early gastrointestinal tumors, to establish Nomogram model and to propose nursing countermeasures.Methods:Data of 236 patients who received ESD in Jiangsu Taizhou People's Hospital due to early gastrointestinal tumor from December 2017 to December 2019 were retrospectively analyzed. The independent risk factors for postoperative delayed bleeding were analyzed by univariate Logistic regression and binary Logistic regression respectively and a Nomogram prediction model was established.Results:Long-term use of antithrombotic drugs ( OR=4.990) , the number of biopsies greater or equal to 3 ( OR=7.834) , accompanied by ulcers and scars ( OR=6.079) , lesion diameter greater or equal to 3 cm ( OR=5.316) , infiltration to submucosa ( OR=5.667) , intraoperative marked bleeding ( OR=5.745) and experience of surgeons ( OR=7.660) were independent risk factors for delayed bleeding after ESD in early gastrointestinal tumors ( P<0.05) . A related Nomogram prediction model was established based on the above 7 independent risk factors, and the model was verified. The H- L deviation test result was χ 2=3.753, P=0.663 and C- index was 0.907 (95% CI 0.877-0.937) , which indicated Nomogram prediction model had good accuracy and dipartite degree. Conclusions:Long-term use of antithrombotic drugs, the number of biopsies greater or equal to 3, accompanied by ulcers and scars, lesion diameter greater or equal to 3 cm, infiltration to submucosa, intraoperative marked bleeding and unskilled surgeons are independent risk factors for delayed bleeding after ESD in early gastrointestinal tumors. Nomogram model established has accurate predictive ability and dipartite degree, which is helpful for nursing staff to screen high-risk patients and formulate relevant nursing strategies.
