Nomogram for predicting the risk of gastroesophageal varices after primary endoscopic prophylaxis for variceal hemorrhage in patients with cirrhosis
Nomogram for predicting the risk of gastroesophageal varices after primary endoscopic prophylaxis for variceal hemorrhage in patients with cirrhosis
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列线图预测肝硬化患者静脉曲张出血初次内镜预防后胃食管静脉曲张的风险
DOI：
10.1097/meg.0000000000001983
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发表时间：
2020-11
影响因子：
2.1
通讯作者：
Changqing Yang
中科院分区：
文献类型：
--
作者：
Shuo Zhang;Weiping Song;Yizhong Chang;Shenglan Wang;Li Yang;Changqing Yang
背景和目的本研究的目的是确定非高危胃食管静脉曲张的预测因素，并评估肝硬化患者初次内镜治疗后残留高危静脉曲张的可能性。患者与方法 回顾性分析入院接受内镜下预防性胃食管静脉曲张出血的肝硬化患者的病历。根据内镜检查结果将患者分为高危静脉曲张组和非高危静脉曲张组。根据多变量 Cox 分析的结果开发了列线图。该模型的准确性通过一致性指数（Harrell 的 c 指数）和校准曲线进行了验证。结果 2014 年 3 月至 2018 年 4 月期间，共有 117 名患者入组。多变量 Cox 分析确定脾长度 <140 mm [比值比 (OR) = 2.715；比值比 (OR) = 2.715； P = 0.037）、小或中型食管静脉曲张（OR = 4.412；P = 0.017）、不伴有胃静脉曲张（OR = 7.025；P = 0.003）和内镜下静脉曲张结扎频率≥每4个月1次（OR = 3.834；P = 0.034）作为独立因素非高危静脉曲张。所有重要的预测因子都被纳入列线图来预测残余高风险静脉曲张，其一致性指数 (0.833) 显示出显着的准确性。结论基于列线图的残余高危静脉曲张预测可用于肝硬化胃食管静脉曲张患者的危险分层。
Background and aims The aim of this study was to identify predictors of non-high-risk gastroesophageal varices and evaluate the probability of the residual high-risk varices in cirrhosis patients after the primary endoscopic treatment. Patients and methods Medical records of the patients with cirrhosis admitted for primary endoscopic prophylaxis gastroesophageal varices hemorrhage were retrospectively analyzed. The patients were divided into high-risk varices and non-high-risk varices groups according to the endoscopy. A nomogram was developed based on the results of multivariate Cox analyses. Accuracy of this model was validated by the concordance index (Harrell’s c-index) and calibration curve. Results Altogether 117 patients were enrolled between March 2014 and April 2018. The multivariate Cox analyses identified spleen length <140 mm [odds ratio (OR) = 2.715; P = 0.037), small or medium size of esophageal varices (OR = 4.412; P = 0.017), unaccompanied with gastric varices (OR = 7.025; P = 0.003) and frequency of endoscopic variceal ligation ≥one time per 4 months (OR = 3.834; P = 0.034) as independent factors of non-high-risk varices. All significant predictors were incorporated into a nomogram to predict the residual high-risk varices, which showed a notable accuracy with the concordance index (0.833). Conclusion The nomogram-based prediction of residual high-risk varices can be used for risk stratification in cirrhosis patients with gastroesophageal varices.
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影响因子：
4.4
作者：
Zardi EM;Di Matteo FM;Pacella CM;Sanyal AJ
通讯作者：
Sanyal AJ
影响因子：
4.5
作者：
Thomopoulos, KC;Labropoulou-Karatza, C;Nikolopoulou, V
通讯作者：
Nikolopoulou, V
影响因子：
4.3
作者：
Kraja B;Mone I;Akshija I;Koçollari A;Prifti S;Burazeri G
通讯作者：
Burazeri G
DOI：
10.1002/jcsm.12333
发表时间：
2018-10
期刊：
Journal of cachexia, sarcopenia and muscle
影响因子：
--
作者：
Kang SH;Jeong WK;Baik SK;Cha SH;Kim MY
通讯作者：
Kim MY
影响因子：
7.7
作者：
Kovalak, Mary;Lake, Jeremy;Zaman, Atif
通讯作者：
Zaman, Atif