Minjee Kim, Chang Wan Choi, E. Kim, Dong Kyung Chang, S. Hong
{"title":"Risk Prediction of Post-Endoscopic Submucosal Dissection Coagulation Syndrome.","authors":"Minjee Kim, Chang Wan Choi, E. Kim, Dong Kyung Chang, S. Hong","doi":"10.1159/000539007","DOIUrl":null,"url":null,"abstract":"INTRODUCTION\nEndoscopic submucosal dissection (ESD) has been popular worldwide to treat laterally spreading tumors and large polyps. Post-ESD coagulation syndrome (PECS) is more common than the two major ESD-related complications, perforation and bleeding. The aim of this study was to assess the prevalence of PECS, identify the risk factors for PECS, and create a risk prediction model for PECS.\n\n\nMETHODS\nRetrospective cross-sectional study analyzed a total of 986 patients who underwent colorectal ESD. Logistic regression models were used to assess risk factors with PECS. Each risk factor was scored and the 3-step risk stratification index of prediction model was assessed.\n\n\nRESULTS\nThe prevalence of PECS was 21.4% (95% confidence interval [CI]=18.9%-24.1%). The risk factors of PECS in the multivariate logistic regression were tumor size (+1 cm: odds ratio [OR], 1.29; 95% CI, 1.16 to 7.09), cecal lesion (OR, 1.96; 95% CI, 1.09 to 1.53), procedure time (+30 minutes: OR, 1.19; 95% CI, 1.02 to 1.39), and ESD with snaring (OR, 0.64; 95% CI, 0.43 to 0.95). Applying a simplified weighted scoring system based on adjusted OR increments of 1, the risk of PECS was 12.3% (95% CI, 0.3%-16.0%) for the low-risk group (score ≤ 4) and was 36.0% (95% CI=29.4%-43.2%) for the high-risk group (score ≥ 8). Overall discrimination (C-statistic=0.629; 95% CI=0.585-0.672) and calibration (p = 0.993) of the model were moderate to good.\n\n\nCONCLUSION\nPECS occurs frequently and the prediction model can be helpful for effective treatment and prevention of PECS.","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000539007","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
INTRODUCTION
Endoscopic submucosal dissection (ESD) has been popular worldwide to treat laterally spreading tumors and large polyps. Post-ESD coagulation syndrome (PECS) is more common than the two major ESD-related complications, perforation and bleeding. The aim of this study was to assess the prevalence of PECS, identify the risk factors for PECS, and create a risk prediction model for PECS.
METHODS
Retrospective cross-sectional study analyzed a total of 986 patients who underwent colorectal ESD. Logistic regression models were used to assess risk factors with PECS. Each risk factor was scored and the 3-step risk stratification index of prediction model was assessed.
RESULTS
The prevalence of PECS was 21.4% (95% confidence interval [CI]=18.9%-24.1%). The risk factors of PECS in the multivariate logistic regression were tumor size (+1 cm: odds ratio [OR], 1.29; 95% CI, 1.16 to 7.09), cecal lesion (OR, 1.96; 95% CI, 1.09 to 1.53), procedure time (+30 minutes: OR, 1.19; 95% CI, 1.02 to 1.39), and ESD with snaring (OR, 0.64; 95% CI, 0.43 to 0.95). Applying a simplified weighted scoring system based on adjusted OR increments of 1, the risk of PECS was 12.3% (95% CI, 0.3%-16.0%) for the low-risk group (score ≤ 4) and was 36.0% (95% CI=29.4%-43.2%) for the high-risk group (score ≥ 8). Overall discrimination (C-statistic=0.629; 95% CI=0.585-0.672) and calibration (p = 0.993) of the model were moderate to good.
CONCLUSION
PECS occurs frequently and the prediction model can be helpful for effective treatment and prevention of PECS.
期刊介绍:
Each issue of this journal is dedicated to a special topic of current interest, covering both clinical and basic science topics in gastrointestinal function and disorders. The contents of each issue are comprehensive and reflect the state of the art, featuring editorials, reviews, mini reviews and original papers. These individual contributions encompass a variety of disciplines including all fields of gastroenterology. ''Digestive Diseases'' bridges the communication gap between advances made in the academic setting and their application in patient care. The journal is a valuable service for clinicians, specialists and physicians-in-training.