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Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors
SIMPLE SUMMARY: BEST-J score is a model for predicting bleeding after gastric endoscopic submucosal dissection (ESD); however, it is complicated. Several post-ESD bleeding prediction models exist but have not been externally validated. Moreover, there are no post-ESD bleeding prediction models that...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688376/ https://www.ncbi.nlm.nih.gov/pubmed/36428648 http://dx.doi.org/10.3390/cancers14225555 |
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author | Okada, Tomoyuki Mikamo, Tsuyoshi Hamamoto, Wataru Iwamoto, Taku Okamoto, Toshiaki Maeda, Kazunori Yanagitani, Atsushi Tanaka, Kiwamu Isomoto, Hajime Yamaguchi, Naoyuki |
author_facet | Okada, Tomoyuki Mikamo, Tsuyoshi Hamamoto, Wataru Iwamoto, Taku Okamoto, Toshiaki Maeda, Kazunori Yanagitani, Atsushi Tanaka, Kiwamu Isomoto, Hajime Yamaguchi, Naoyuki |
author_sort | Okada, Tomoyuki |
collection | PubMed |
description | SIMPLE SUMMARY: BEST-J score is a model for predicting bleeding after gastric endoscopic submucosal dissection (ESD); however, it is complicated. Several post-ESD bleeding prediction models exist but have not been externally validated. Moreover, there are no post-ESD bleeding prediction models that incorporate nutritional indicators. This study aimed to predict post-ESD bleeding more simply by incorporating nutritional indicators and verify generalizability using an external cohort. This study could more quickly predict post-ESD bleeding. ABSTRACT: This study constructed a simplified post-endoscopic submucosal dissection (ESD) prediction model with a prognostic nutritional index (PNI). A total of 449 patients who underwent gastric ESD was included, divided with a ratio of 2:1, and assigned to the model or validation cohort. A prediction model of post-ESD (modified BEST-J score) was constructed using the model cohort. The modified BEST-J score was evaluated by comparing its accuracy to the BEST-J score in the validation cohort. Within 4 weeks of ESD, melena, hematemesis, or a 2 g/dL or greater decrease in hemoglobin level that required esophagogastroduodenoscopy was defined as post-ESD bleeding. In the model cohort, 299 patients were enrolled and 25 (8.4%) had post-ESD bleeding. Independent risk factors for post-ESD bleeding were use of P2Y12RA, tumor size > 30 mm, location of lesion at lower one-third of the stomach, and PNI [Formula: see text] 47.9. Constructing the modified BEST-J score based on these variables, the sensitivity, specificity, and positive likelihood ratio were 73.9%, 78.1%, and 3.37. When comparing the modified BEST-J score to the BEST-J score in the validation cohort, no significant difference was observed by ROC-AUC (0.77 vs. 0.75, p = 0.81). Modified BEST-J score can predict post-ESD bleeding more simply, with the same accuracy as the BEST-J score. |
format | Online Article Text |
id | pubmed-9688376 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96883762022-11-25 Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors Okada, Tomoyuki Mikamo, Tsuyoshi Hamamoto, Wataru Iwamoto, Taku Okamoto, Toshiaki Maeda, Kazunori Yanagitani, Atsushi Tanaka, Kiwamu Isomoto, Hajime Yamaguchi, Naoyuki Cancers (Basel) Article SIMPLE SUMMARY: BEST-J score is a model for predicting bleeding after gastric endoscopic submucosal dissection (ESD); however, it is complicated. Several post-ESD bleeding prediction models exist but have not been externally validated. Moreover, there are no post-ESD bleeding prediction models that incorporate nutritional indicators. This study aimed to predict post-ESD bleeding more simply by incorporating nutritional indicators and verify generalizability using an external cohort. This study could more quickly predict post-ESD bleeding. ABSTRACT: This study constructed a simplified post-endoscopic submucosal dissection (ESD) prediction model with a prognostic nutritional index (PNI). A total of 449 patients who underwent gastric ESD was included, divided with a ratio of 2:1, and assigned to the model or validation cohort. A prediction model of post-ESD (modified BEST-J score) was constructed using the model cohort. The modified BEST-J score was evaluated by comparing its accuracy to the BEST-J score in the validation cohort. Within 4 weeks of ESD, melena, hematemesis, or a 2 g/dL or greater decrease in hemoglobin level that required esophagogastroduodenoscopy was defined as post-ESD bleeding. In the model cohort, 299 patients were enrolled and 25 (8.4%) had post-ESD bleeding. Independent risk factors for post-ESD bleeding were use of P2Y12RA, tumor size > 30 mm, location of lesion at lower one-third of the stomach, and PNI [Formula: see text] 47.9. Constructing the modified BEST-J score based on these variables, the sensitivity, specificity, and positive likelihood ratio were 73.9%, 78.1%, and 3.37. When comparing the modified BEST-J score to the BEST-J score in the validation cohort, no significant difference was observed by ROC-AUC (0.77 vs. 0.75, p = 0.81). Modified BEST-J score can predict post-ESD bleeding more simply, with the same accuracy as the BEST-J score. MDPI 2022-11-12 /pmc/articles/PMC9688376/ /pubmed/36428648 http://dx.doi.org/10.3390/cancers14225555 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Okada, Tomoyuki Mikamo, Tsuyoshi Hamamoto, Wataru Iwamoto, Taku Okamoto, Toshiaki Maeda, Kazunori Yanagitani, Atsushi Tanaka, Kiwamu Isomoto, Hajime Yamaguchi, Naoyuki Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors |
title | Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors |
title_full | Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors |
title_fullStr | Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors |
title_full_unstemmed | Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors |
title_short | Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors |
title_sort | modified best-j score model predicts bleeding after endoscopic submucosal dissection with fewer factors |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688376/ https://www.ncbi.nlm.nih.gov/pubmed/36428648 http://dx.doi.org/10.3390/cancers14225555 |
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