Risk factors and predictive nomograms of bedside emergency endoscopic treatment of esophagogastric variceal bleeding in cirrhotic patients with endotracheal intubation

Abstract The data on the clinical practice of emergency endoscopic therapy following endotracheal intubation in remain limited. In this retrospective study, we aimed to explore the efficacy and risk factors of bedside emergency endoscopic treatment following endotracheal intubation in (EGVB) patients. The included EGVB patients were allocated to training and validation sets in a randomly stratified manner. Univariate and multivariate logistic regression analyses were used to identify independent risk factors to construct nomograms for predict the prognosis related to endoscopic hemostasis failure rate and 6-week mortality. In result, WBC (p = 0.03), CTP score (p= 0.001) and comorbid shock (p= 0.005) were selected as independent clinical predictors of endoscopic hemostasis failure. High CTP score (p = 0.003) and gastric varices (p= 0.009) were related to early rebleeding after emergency endoscopic treatment. Furthermore, the 6-week mortality was significantly associated with MELD scores (p = 0.002), the presence of hepatic encephalopathy (p=0.045) and postoperative rebleeding (p< 0.001). Finally, we developed practical nomograms to discern the risk of the emergency endoscopic hemostasis failure and 6-week mortality for EGVB patients, which may help identify high-risk patients for earlier implementation of aggressive treatments.