A novel scoring system has been developed to predict the risk of reintervention within 30 days after endoscopic sleeve gastroplasty (ESG). The scoring system, known as ESG reintervention scoring system (ESGRS), was created using data from 3,583 patients who underwent ESG between 2016 and 2021. The study found that a 30-day endoscopic reintervention rate for ESG was 3.3%. The ESGRS identified five significant predictors of reintervention: history of foregut surgery, preoperative anticoagulation use, female sex, American Society of Anesthesiologists Classification score of 2 or greater, and hypertension. The internal validation of the ESGRS showed a 74% probability of predicting ESG reintervention within 30 days. An optimal cut point of 67.9 was identified, with a sensitivity and specificity of 0.76 and 0.71, respectively. An ESGRS of at least 67.9 had a positive predictive value of 76.1%, while an ESGRS of less than 67.9 had a negative predictive value of 61%. The findings provide valuable guidance for clinicians in assessing the risk of reintervention before performing ESG and have the potential to reduce the risk for patients. Further research is needed to validate the ESGRS in different patient populations and clinical settings and improve its predictive accuracy.

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