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Nomogram for Predicting the Risk of Complications after Endoscopic Foreign Body Removal from the Adult Upper Gastrointestinal Tract

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Abstract

Background

Ingested foreign bodies may become impacted in the upper gastrointestinal tract, requiring endoscopic removal.

Aims

To establish and validate a nomogram to determine the risk of complications following endoscopic foreign body removal.

Methods

We retrospectively analyzed the data of 1510 adult patients who underwent endoscopic removal of ingested foreign bodies between January 2019 and December 2022. All participants were randomly allocated in a 7:3 ratio to the training (n = 1057) and validation (n = 453) cohorts. A nomogram for the development of major complications associated with endoscopic foreign body removal was established based on risk factors identified by logistic regression analysis.

Results

Four independent risk factors for the development of major complications were identified by multivariate regression analysis: older age, impaction time > 24 h, type of foreign body (animal bones and jujube pits), and number of pressure points exerted on the digestive tract wall (one and ≥ two). The nomogram constructed using these factors showed favorable discriminatory values, with an area under the curve of 0.76 (95% confidence interval, 0.73–0.78) in the training cohort and 0.74 (95% confidence interval, 0.72–0.76) in the validation cohort.

Conclusions

Older patients who ingested bones or jujube pits with more pressure points exerted on the digestive tract wall more than 24 h earlier should be considered most at risk of major complications after endoscopic removal of foreign bodies. The nomogram established in this study can be conveniently used to assess patients and develop treatment plans for the management of foreign body ingestion.

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Funding

This work was supported by the Jiangsu Province 333 High-level Talent Training Project (grant no. LGY2016010) and Jiangsu Province Six Talent Peaks (grant no. WSN-030).

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong, 226000, China

    Zhe Chen

  2. Department of Gastroenterology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210000, Jiangsu Province, China

    Minhao Yin, Peichen Xia, Xu Han & Hong Zhu

Authors
  1. Zhe Chen
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  2. Minhao Yin
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  3. Peichen Xia
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  4. Xu Han
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  5. Hong Zhu
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Contributions

All authors contributed to the study conception and design. The first draft of the manuscript was written by Zhe Chen. Minhao Yin participated in its subsequent editing. Material preparation, data collection, and analysis were performed by Peichen Xia and Xu Han. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hong Zhu.

Ethics declarations

Ethics approval and consent to participate

All procedures involving human participants performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (approval no. 2022-SR-088).

Consent to participate

The requirement for written informed consent was waived due to the retrospective nature of the study.

Competing interests

The authors declare that they have no conflicts of interest.

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Chen, Z., Yin, M., Xia, P. et al. Nomogram for Predicting the Risk of Complications after Endoscopic Foreign Body Removal from the Adult Upper Gastrointestinal Tract. Dig Dis Sci 69, 1361–1371 (2024). https://doi.org/10.1007/s10620-024-08343-7

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  • DOI: https://doi.org/10.1007/s10620-024-08343-7

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