Tóm tắt

Background: Colorectal cancer (CRC) is a common malignancy, and colonoscopy remains the most important diagnostic modality. However, not all hospitalized patients with lower gastrointestinal symptoms have malignant lesions. Identifying clinical predictors is essential for optimizing colonoscopy indications. This study aims to identify clinical predictors of malignant colorectal lesions among hospitalized patients undergoing colonoscopy.

Methods: A retrospective analytical cross-sectional study was conducted in 148 hospitalized patients who underwent colonoscopy. Clinical characteristics, comorbidities, and laboratory data were collected. Logistic regression analysis was used to identify independent predictors. Model performance was evaluated using receiver operating characteristic (ROC) analysis, Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis.

Results: The prevalence of malignant colorectal lesions (adenocarcinoma) was 8.8%. In multivariable analysis, unexplained weight loss (OR=16.96; p=0.004) and type 2 diabetes mellitus (OR=6.12; p=0.019) were independent predictors. Hematochezia and body mass index showed borderline associations but were not significant after adjustment. The prediction model demonstrated good discrimination (AUC=0.85) and provided net clinical benefit across relevant threshold probabilities .

Conclusions: Unexplained weight loss and type 2 diabetes mellitus were independently associated with malignant colorectal lesions in hospitalized patients. The proposed model may support preliminary risk stratification, although further validation in larger multicenter studies is needed.