Abstract
OBJECTIVE: To investigate the risk factors for rebleeding in patients with IIb peptic ulcer bleeding (PUB) treated endoscopically and to develop a nomogram model. METHOD: A retrospective analysis was conducted on 287 patients with grade IIb PUB who underwent endoscopic treatment at Beijing Pinggu Hospital from January 2019 to December 2023. The patients were divided into a modelling cohort (n=201) and a validation cohort (n=86) in a 7:3 ratio. The modelling cohort consisted of a non-bleeding (NB) group (n=176) and a re-bleeding (RB) group (n=25), while the validation cohort included an NB group (n=75) and an RB group (n=11). Logistic regression was used to analyze and identify the risk factors for rebleeding after endoscopic treatment in class IIb PUB patients. Based on the results of Logistic regression, a nomogram model was developed, and receiver operating characteristic (ROC) curve and calibration curve were performed to evaluate its accuracy. RESULTS: Ulcer site, ulcer diameter, Helicobacter pylori (Hp) infection, D-dimer (D-D), prothrombin time (PT), albumin (ALB), and prostaglandin E2 (PGE2) were associated with rebleeding after endoscopic treatment in grade IIb PUB patients (all P<0.05). Logistic regression analysis identified Hp infection (OR=9.723, P=0.007), D-D (OR=1.013, P=0.047), PT (OR=2.242, P=0.013), ALB (OR=0.899, P=0.036), and PGE2 (OR=0.987, P=0.042) as independent risk factors for rebleeding. The area under the ROC curve for the nomogram model constructed based on these factors was 0.875 (95% CI: 0.788-0.962). CONCLUSION: This study successfully identified key independent risk factors for rebleeding after endoscopic treatment in grade IIb PUB patients, providing clinicians with a scientific decision-making tool to reduce rebleeding risk and improve treatment outcomes.