To explore the risk factors of rebleeding in patients with liver cirrhosis complicated with esophageal and gastric varices rupture and bleeding (EVB) treated by endoscopy, and to establish a corresponding predictive model.

A total of 109 patients with liver cirrhosis complicated with EVB who visited the First People's Hospital of Changzhou from August 2022 to August 2024 were retrospectively included. The rebleeding situation was followed up for one year after endoscopic treatment. They were divided into the rebleeding group (17 cases) and the non-rebleeding group (92 cases) according to whether there was rebleeding after treatment. Univariate analysis was used to analyze the relationship between various clinical indicators and rebleeding after endoscopic treatment. A predictive model was established, the model's fit degree was evaluated, and its clinical value was analyzed.

The hemostasis success rate of 109 patients within 72 hours after endoscopic treatment was 100%. During the 1-year follow-up, 17 cases (15.59%) experienced rebleeding. Gender, age, etiology of liver cirrhosis, degree of esophageal varices, gastric fundus varices, infection, white blood cell count, platelet count, urea nitrogen, creatinine, serum protein, prothrombin time, fibrinogen, portal vein diameter, splenic vein diameter and spleen thickness were all not related to the risk of rebleeding in patients with liver cirrhosis complicated with EVB after endoscopic treatment (P>0.05). The treatment methods, portal vein emboli, total bilirubin, hemoglobin, ascites and Child-Pugh classification were related to the risk of rebleeding in patients with liver cirrhosis complicated with EVB treated by endoscopy (P<0.05). The results of Logistic regression analysis showed that portal vein emboli, hemoglobin, combined ascites and Child-Pugh classification were independent risk factors for rebleeding in patients with liver cirrhosis complicated with EVB treated by endoscopy (P<0.05). Based on the above four indicators, a nomogram model was established. The C-index was 0.877, and the calibration curve fitted well. The area under the ROC curve of the model was 0.877 (95% CI: 0.798-0.928, P<0.001).

The nomogram constructed based on portal vein emboli, hemoglobin, combined ascites and Child-Pugh classification can effectively predict the risk of rebleeding in patients with liver cirrhosis complicated with EVB treated by endoscopy, and has good clinical application value.