Deng DW, Leng AX, He Q, Zhou CG. Nomogram for prediction of six-month mortality following endovascular treatment of delayed post-pancreatectomy hemorrhage. World J Gastrointest Surg 2025; 17(12): 113029 [DOI: 10.4240/wjgs.v17.i12.113029]
Corresponding Author of This Article
Qiang He, PhD, Chief Physician, Full Professor, Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 South Gongren Tiyuchang Road, Chaoyang District, Beijing 100020, China. heqiang349@sina.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 27, 2025 (publication date) through Dec 25, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Deng DW, Leng AX, He Q, Zhou CG. Nomogram for prediction of six-month mortality following endovascular treatment of delayed post-pancreatectomy hemorrhage. World J Gastrointest Surg 2025; 17(12): 113029 [DOI: 10.4240/wjgs.v17.i12.113029]
Ding-Wei Deng, Chuan-Guo Zhou, Department of Interventional Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
Ai-Xin Leng, Qiang He, Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
Co-first authors: Ding-Wei Deng and Ai-Xin Leng.
Co-corresponding authors: Qiang He and Chuan-Guo Zhou.
Author contributions: Deng DW and Zhou CG designed the research and performed the endovascular interventions; Leng AX and He Q collected clinical data and drafted the manuscript; Deng DW and Leng AX contributed equally to this manuscript and are co-first authors; He Q and Zhou CG contributed equally to this manuscript and are co-corresponding authors. All authors critically revised the manuscript and approved the final version.
Institutional review board statement: This study was approved by the Institutional Review Board of Beijing Chao-Yang Hospital, Capital Medical University (Approval No. 2024-6-24-2).
Informed consent statement: Given the retrospective nature of the analysis, the requirement for informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated or analyzed during this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang He, PhD, Chief Physician, Full Professor, Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 South Gongren Tiyuchang Road, Chaoyang District, Beijing 100020, China. heqiang349@sina.com
Received: August 13, 2025 Revised: September 16, 2025 Accepted: November 5, 2025 Published online: December 27, 2025 Processing time: 134 Days and 10.3 Hours
Abstract
BACKGROUND
Delayed post-pancreatectomy hemorrhage (PPH) is life-threatening, and endovascular interventions show promise. This retrospective study aimed to evaluate endovascular treatment outcomes for delayed PPH and identify mortality risk factors.
AIM
To conduct a single-center retrospective study of 88 patients with delayed PPH to systematically evaluate the clinical efficacy of endovascular treatment, identify independent risk factors for six-month mortality, and propose and validate a predictive model for individualized management of high-risk patients.
METHODS
This retrospective analysis included 88 patients with delayed PPH treated by endovascular intervention. Patients were stratified into survival (n = 64) and mortality (n = 24) groups. Clinical and procedural variables were assessed using univariate and multivariate logistic regression. Significant predictors were incorporated into a prognostic nomogram. Model performance was assessed through discrimination (area under the receiver operating characteristic curve), calibration, and decision curve analysis.
RESULTS
Technical and clinical success rates were 92.0% and 60.2%, respectively. The overall six-month mortality rate was 27.3% (24/88). Independent predictors of mortality included advanced age, prolonged operative time, shorter hospital stay, intra-abdominal infection, coagulation dysfunction, common hepatic artery bleeding, and failure to achieve clinical success. The nomogram demonstrated excellent discrimination (area under the receiver operating characteristic curve = 0.943), with good calibration and favorable net benefit on decision curve analysis.
CONCLUSION
We proposed and validated a predictive nomogram for six-month mortality following endovascular treatment for delayed PPH. The model facilitates individualized risk stratification and may guide clinical decision-making. Early identification of high-risk patients - particularly older individuals or those with infection or coagulopathy - and prompt, personalized intervention may improve outcomes in this high-risk population.
Core Tip: This retrospective study is the first to establish and validate a nomogram for predicting six-month mortality in patients with delayed post-pancreatectomy hemorrhage treated with endovascular intervention. By retrospectively analyzing 88 cases, several independent prognostic factors were identified, including advanced age, prolonged operative time, shorter in-hospital days, intra-abdominal infection, coagulation abnormalities, and clinical failure. Notably, bleeding from the common hepatic artery was confirmed as an independent predictor of mortality. The proposed nomogram demonstrated good discrimination and clinical applicability, offering a practical tool for individualized risk stratification and management in high-risk post-pancreatectomy hemorrhage patients.
