Prognostic logistic regression model for assessing indications for therapeutic implantation with gastric prolapse into the esophagus or the cardiac part of the stomach
DOI:
https://doi.org/10.17721/1812-5409.2025/2.4Keywords:
logistic regression, prognostic model, medical implantation, gastric prolapse, endoscopic predictors, clinical decisionAbstract
In this study, a prognostic model based on logistic regression was developed to assess the indications for therapeutic implantation in patients with gastric prolapse into the esophagus or the gastric cardia. The analysis was performed on clinical and endoscopic data from 558 patients of the Endoscopy Department of the Kirovohrad Regional Hospital. The model incorporated nine predictors: complaints of heartburn, regurgitation, retrosternal pressure, hoarseness, presence of mucosal defects according to the Los Angeles classification, height of gastric prolapse into the esophagus or the gastric cardia, the position of the Z-line, and the presence of hematin-covered erosions or ulcers. Special attention was devoted to the medical interpretation of the estimated coefficients, standard errors, Wald statistics, variance–covariance matrices, odds ratios, and other model diagnostics. This approach enabled not only the evaluation of the statistical significance of the predictors but also the understanding of their clinical relevance in predicting the feasibility of implantation in individual patients. To analyze dependencies among predictors, contingency tables and Cramér's V coefficients were applied, which revealed weak to moderate associations between symptoms and justified retaining all predictors in the model. To assess the significance of the model, the Cox and Snell coefficients of determination, the modified Nagelker coefficient of determination, the Hosmer – Lemeshov test, and the classification table for the model were used. The results demonstrate a high predictive ability of the model (accuracy of 98.6%) and confirm the clinical significance of even rare symptoms.
Pages of the article in the issue: 31 - 35
Language of the article: Ukrainian
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