Developing a nomogram for predicting patients’ 24h-fatigue after digestive endoscopy with anesthesia assistance: a cross-sectional study

Abstract

Background Postoperative fatigue (POF) widely exists in patients underwent digestive endoscopy under anesthesia, seriously affecting patients’ postoperative rehabilitation and quality of life, there is few predicted tools for POF. We aim to identify predictors of 24 hours-postoperative fatigue (24h-POF) in patients underwent digestive endoscopy with anesthesia assistance and develop a nomogram. Methods This cross-sectional study involved 1306 patients underwent digestive endoscopy in The Second Affiliated Hospital Zhejiang University School of Medicine from May to November in 2023. Christensen Fatigue Scale was used to evaluate POF. Multiple linear regression analysis was utilized to ascertain independent predictors, and a nomogram was developed based on these findings. The area under the curve (AUC), calibration curve and decision curve analysis (DCA) were employed to evaluate the predictive model’s performance. Results 528 patients (40.43%) reported experiencing 24h-POF. Five modifiable factors (preoperative anxiety, average dosage of propofol, change rates of heart rate, fatigue 30 min after endoscopy, intraoperative hypotension) and nine non-modifiable factors (age, gender, drinker, numbers of comorbidities, degree of education, marital, Buddhist, endoscopic treatment, intraoperative tracheal intubation) were independently associated with 24h-POF in patients undergoing digestive endoscopy. The model exhibited good discrimination with an AUC of 0.865 and 0.891 in training cohort and validation cohort, respectively. The calibration curves and DCA curves demonstrated excellent calibration and clinical practicability. Conclusion The nomogram can effectively predict 24h-POF of digestive endoscopic patients, providing valuable assistance for early intervention to expedite patient recovery.