Establishing a nomogram for predicting the risk factors for delayed bleeding after endoscopic submucosal dissection for colorectal tumors.

Abstract

Background: The aim of this study is to establish a nomogram that can predict the risk factors for delayed bleeding after endoscopic submucosal dissection (ESD). This model can be used to assess the probability of delayed bleeding before ESD surgery, thereby avoiding wasting medical resources and improving patient satisfaction.

Methods: This was a retrospective study in which all patients underwent ESD surgery for colorectal tumors between August 2021 and February 2024. Patient demographics and surgical characteristics were collected. All patients were randomly divided into a training set and a testing set. Univariate and multivariate regression analyses of the training set revealed the independent risk factors for delayed bleeding after ESD. These independent risk factors were used to construct a nomogram model. This model was validated using internal validation methods such as the C-index, calibration curve, and decision curve analysis.

Results: This study included 587 patients. The occurrence rate of delayed bleeding after ESD in the training set was 8.98%. Multivariate regression analysis revealed that the location of the lesion in the rectum, a large lesion, and a prolonged surgery time were independent risk factors for delayed bleeding after ESD. The C-index for this model was 0.89, and validation of this nomogram model demonstrated good consistency between the predicted and actual values.

Conclusion: Multivariate regression analysis revealed the independent risk factors for delayed bleeding after ESD, and a nomogram with a relatively consistent accuracy was established. The clinical application of this model can reduce the incidence of delayed bleeding and therefore improve patient healing.