To explore the relevant risk factors for rebleeding after endoscopic treatment in patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding, and to construct and validate the value of a nomogram model.

s A retrospective analysis method was used to select patients with cirrhosis complicated with variceal bleeding who received endoscopic treatment in Shijiazhuang People's Hospital from January 2022 to January 2023. All patients were randomly divided into a training set and a validation set. A multivariate logistic regression model was used to analyze the risk factors for recurrent bleeding, and a nomogram prediction model was established based on the risk factors. The nomogram model was verified using receiver operating characteristic curve (ROC curve), Hosmer-Lemeshow test, and decision curve analysis.

A total of 153 patients with cirrhosis combined with esophageal and gastric variceal bleeding who underwent endoscopic treatment were included in this study, of which 38 cases (25.49%) experienced recurrent bleeding. The results of univariate analysis showed that body mass index (BMI), liver hardness, portal vein diameter, hemoglobin, platelet count, glutamyltransferase (GGT), Child Pugh grading, and model for end-stage liver disease (MELD) score were the factors affecting rebleeding in patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding treated with endoscopy, and there were statistically significant differences (P<0.05). Multivariate logistic regression analysis showed that BMI, liver hardness, hemoglobin, platelet count, and MELD score were risk factors for rebleeding in patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding treated with endoscopy, and there were statistically significant differences (P<0.05). Based on the above risk factors, a line segment nomogram model was constructed, with scores assigned to each factor. The total score was -4 to 4, and the corresponding risk rate range was 0.02 to 0.97. The higher the score, the greater the risk of rebleeding in patients with liver cirrhosis combined with esophageal and gastric variceal bleeding who undergo endoscopic treatment. The area under the ROC curve of the training set model was 0.873 (95% CI: 0.807-0.939), and the area under the ROC curve of the validation set was 0.772 (95% CI: 0.584-0.959). The results of the Hosmer-Lemeshow test on the calibration curves of the training and validation sets indicated that the calibration curves approached the ideal curve without significant differences (χ²=3.231, 2.397, P=0.919, 0.934). Clinical decision curve analysis shows that the model had clinical practicality.

A nomogram model for the risk of rebleeding in patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding after endoscopic treatment is constructed and validated, which has good accuracy, calibration, and clinical practicality.