老年医学与保健2025，Vol.31Issue(2)：493-498,503,7.
老年肝硬化食管胃静脉曲张出血患者内镜治疗后再出血预测模型的建立与验证
Establishment and validation of a predictive model for rebleeding after endoscopic treatment in elderly patients with liver cir-rhosis and esophagogastric variceal bleeding
摘要
Abstract
Objective To develop and validate a predictive model for rebleeding after endoscopic treatment in elderly patients with liver cirrhosis and esophagogastric variceal bleeding(EGVB)based on longitudinal cohort data.Methods The clinical data of 182 elderly patients with cirrhotic EGVB treated in Shuguang Hospital Affiliated to Shanghai University of Tradi-tional Chinese Medicine from April 2015 to April 2023 were retrospectively collected.LASSO regression was used to screen variables.A Cox proportional hazards model was constructed and its performance was evaluated.Internal validation was con-ducted via Bootstrap method.Results LASSO regression identified the following risk factors for rebleeding:ascites(HR=3.96),bacterial infection(HR=2.66),portal vein thrombosis(HR=2.46),and white blood cell count(HR=1.12).Pro-tective factors included elevated D-dimer(HR=0.92)and albumin levels(HR=0.87).The 12-month rebleeding prediction consistency index of the model was 0.818,and the Brier index was 0.115.The discrimination and accuracy were good,which was superior to the Child-Pugh score and MELD score.It also showed good discrimination and accuracy at 3 months and 6 months.Internal validation also showed good predictive ability.Conclusion This study established a predictive model for re-bleeding in elderly patients with cirrhotic EGVB after endoscopic treatment.It may have a good predictive ability for rebleeding events at different periods.关键词
老年/肝硬化/食管胃静脉曲张破裂出血/再出血/预测模型Key words
elderly/liver cirrhosis/esophagogastric variceal bleeding/rebleeding/predictive model引用本文复制引用
余金钟,赵玉洁,王德昕,慕永平,战俊邑..老年肝硬化食管胃静脉曲张出血患者内镜治疗后再出血预测模型的建立与验证[J].老年医学与保健,2025,31(2):493-498,503,7.基金项目
上海市临床重点专科建设项目(shslczdzk01201) （shslczdzk01201）
