Construction of a normogram model for predicting the risk of esophageal and gastric varices bleeding in cirrhosis
Objective To evaluate the risk factors of esophagogastric variceal bleeding(EVGB)for patients with hepatitis B virus(HBV)-related cirrhosis,and to construct a nomogram model to predict the risk of EVGB.Methods A total of 300 HBV-related cirrhotic patients admitted to Nantong Third Hospital Affiliated to Nantong University from January 2019 to January 2022 were selected as the study objects.The independent risk factors of EVGB were determined by the univariate and multivariate Logistic regression analysis,and a nomogram for predicting the risk of EVGB was constructed.The discriminative ability of the nomogram model for high-risk individual with EVGB was evaluated using the area under curve(AUC)of receiver operation characteristics(ROC)curve.Calibration curves were plotted to compare the consistency between the predicted risk and actual risk.Results A total of 131 patients(43.7％)had a history of EVGB,and the results of univariate and multivariate Logistic regression analysis revealed that ascites(OR=6.186,95％CI:3.286-11.644,P＜0.001),platelet count(OR=0.983,95％CI:0.978-0.989,P＜0.001),serum albumin(OR=0.963,95％CI:0.928-0.999,P=0.042)and blood glucose level(OR=1.093,95％CI:1.003-1.190,P=0.042)were independent risk factors for EVGB.Based on the above variables,a nomogram was constructed to predict the risk of EVGB in cirrhotic patients.The AUC value was 0.826(95％CI:0.780-0.872),suggesting a good predictive ability.The calibration curve showed a high level of consistency between the predicted risk and the actual risk.Conclusion Ascites,platelet count,serum albumin and blood glucose level are significantly correlated with the risk of EGVB in liver cirrhosis.The nomogram based on these variables has good predictive ability for the risk of EGVB,and it may help medical staffs make prevention strategy and clinical interventions.
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