Risk Prediction Model for Rebleeding After Endoscopic Variceal Ligation in HBV-Related Cirrhosis Patients with Gastroesophageal Varices
Objective To investigate the risk factors for rebleeding after endoscopic esophageal variceal ligation (EVL) in patients with HBV-related cirrhosis and to establish a predictive model. Methods A total of 294 patients with HBV-re-lated cirrhosis and gastroesophageal varices treated with EVL were retrospectively analyzed. Rebleeding incidence and clinical data were collected during a 1-year postoperative follow-up. Multivariate Logistic regression analysis was performed to iden-tify factors influencing rebleeding. A predictive model was constructed based on Logistic regression. The model's efficacy was evaluated using receiver operating characteristic (ROC) curves and Hosmer-Lemeshow tests. Results Among 294 patients,rebleeding occurred in 73 cases,with a rebleeding rate of 24.83％. Multivariate Logistic regression analysis indicated that high HVPG,portal vein thrombosis,and Child-Pugh grade C were independent risk factors,while antiviral therapy was a protective factor (P<0.05). The Hosmer-Lemeshow test demonstrated a good fit between the predictive model and observed data (P>0.05). ROC analysis showed that the area under the curve (AUC) for predicting rebleeding was 0.844,indicating high predictive effica-cy (P<0.05). Conclusion High HVPG,portal vein thrombosis,and Child-Pugh grade C are risk factors for rebleeding after EVL in HBV-related cirrhosis patients with gastroesophageal varices,while antiviral therapy serves as a protective factor. The predictive model shows good performance and is valuable for clinical decision-making.
万方数据
维普
