Development and validation of a predictive model for 90-day mortality risk after discharge in patients with cirrhosis and esophagogastric variceal bleeding

Esophagogastric variceal bleeding caused by portal hypertension is one of the leading causes of death in patients with cirrhosis. This study aims to develop a simple and user-friendly nomogram predictive model to assess the prognosis of patients with cirrhosis and esophagogastric variceal bleeding.This retrospective study analyzed patients with cirrhosis and esophagogastric variceal bleeding admitted to the Affiliated Hospital of Southwest Medical University between April 2021 and April 2024. Clinical and laboratory data from 253 patients were collected, and participants were randomly divided into a training group and a validation group (7:3). Univariate and multivariate logistic regression analyses were performed to identify independent predictors of mortality in these patients, and a nomogram predictive model was developed. The model's discrimination, accuracy, and clinical utility were evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis.The study identified eosinophil percentage, D-dimer, fibrin degradation products, and portal vein diameter as independent risk factors for mortality in patients with cirrhosis and esophagogastric variceal bleeding. The AUCs for the training and validation datasets were 0.948 and 0.886, respectively. The calibration and decision curves demonstrated good discrimination, calibration, and clinical applicability of the predictive model.The nomogram predictive model developed in this study is a non-invasive, rapid, and effective screening tool for early identification of high-risk patients with cirrhosis and esophagogastric variceal bleeding.