Observational studyBMC gastroenterology2025
Development and validation of a novel nomogram incorporating psychosocial factors for predicting hypoglycemia during perioperative period of digestive endoscopy (DREAM-Hypo Model).
Observational study in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07132476 (The Construction and Validation of a Risk Prediction Model for Perioperative Hypoglycemia in Digestive Endoscopy), which is not on this map. Not yet cited in PubMed.
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The Construction and Validation of a Risk Prediction Model for Perioperative Hypoglycemia in Digestive Endoscopy
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4 authors.
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Abstract
backgroundPerioperative hypoglycemia during digestive endoscopy poses significant risks, with reported incidence rates of 6.75-18.70%. Traditional models focus on metabolic factors, while psychosocial stressors (anxiety, poor sleep quality) may exacerbate risk through neuroendocrine dysregulation. This study aims to develop a novel nomogram (DREAM-Hypo Model) integrating psychosocial, clinical, and metabolic predictors for hypoglycemia risk stratification.
methodsWe prospectively enrolled 610 patients undergoing therapeutic digestive endoscopy at The First Affiliated Hospital of Ningbo University, China (Jan-Jun 2024). Participants were randomly allocated to training and validation cohorts (7:3 ratio). Predictors were identified via univariate and multivariate logistic regression. Model performance was assessed using ROC curves, calibration plots, and decision curve analysis (DCA), with internal validation via 500 bootstrap resamples.
methodsWe prospectively enrolled 610 patients undergoing therapeutic digestive endoscopy at The First Affiliated Hospital of Ningbo University, China (Jan-Jun 2024). Participants were randomly allocated to training and validation cohorts (7:3 ratio). Predictors were identified via univariate and multivariate logistic regression. Model performance was assessed using ROC curves, calibration plots, and decision curve analysis (DCA), with internal validation via 500 bootstrap resamples.
resultsThe overall hypoglycemia incidence was 14.92%. Six independent predictors were identified: fasting time, anxiety, sleep quality, male gender, diabetes, and somatostatin use (all p<0.05). The nomogram showed strong discrimination (training cohort AUC: 0.830, 95% CI: 0.795-0.865; validation cohort AUC: 0.809, 95% CI: 0.752-0.866). DCA confirmed clinical utility, with superior net benefits at thresholds of 25-30%.
conclusionThe DREAM-Hypo nomogram effectively integrates metabolic, procedural, and psychosocial factors to predict perioperative hypoglycemia risk, supporting individualized risk stratification and targeted interventions.
trial registrationClinicalTrials.gov, NCT07132476. Registered on August 19, 2025.National Medical Research Registration and Filing Information System, MR-3-25-035244. Registered on May 7, 2025.
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