Early warning model of delayed bleeding after endoscopic submucosal dissection for early gastric cancer
Objective To explore the risk factors of delayed bleeding after endoscopic submucosal dissection in patients with early gas-tric cancer and establish a risk warning model.Methods A total of 180 patients with early gastric cancer who underwent endoscopic submu-cosal dissection from January 2020 to January 2023 were selected as the study objects.The patients were divided into the delayed postoperative bleeding group and non-delayed postoperative bleeding group according to whether the patients had delayed postoperative bleeding.The clini-cal data were collected for univariate and multivariate regression analysis to obtain the independent predictive factors,and build a nomogram risk model based on that,and evaluate the predictive efficacy of the model.Results The incidence of postoperative delayed hemorrhage was 18.33%.The results of univariate analysis showed that lesion site,lesion diameter,depth of infiltration,long-term administration of antithrom-botic drugs,number of biopsies,ulcer and scar,operation time,intraoperative blood loss,D-D,PT,APTT and PLT were the main factors af-fecting postoperative delayed bleeding after endoscopic submucosal dissection in patients with early gastric cancer.The lesion was located in the cardia,accompanied by cardiac lesion,long-term use of antithrombotic drugs,ulcers and scars,operation time and APTT were independ-ent risk factors(P＜0.05).The C-index index of the model was 0.992,which was close to the C-index of 0.990 verified with Bootstrap for 1 000 times.The overall trend of the model correction curve was close to the ideal curve.Conclusion The occurrence of delayed bleeding af-ter endoscopic submucosal dissection in early gastric cancer patients is affected by multiple factors.The risk early warning model established based on risk factors has good predictive efficacy,which is helpful for clinical nurses to identify high-risk patients with delayed bleeding after endoscopic submucosal dissection in early gastric cancer patients.
early gastric cancerendoscopic submucosal dissectiondelayed postoperative bleedingrisk early warning mode
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