title: Risk factors for bleeding after endoscopic mucosal resection.
abstract: OBJECTIVE
  To clarify the risk factors for bleeding after endoscopic mucosal resection (EMR).
  
  
  METHODS
  A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Bleeding requiring endoscopic treatment was defined as bleeding after EMR. Odds ratios (OR) with 95% confidence intervals (CI), calculated by logistic regression with multivariate adjustments for covariates, were the measures of association.
  
  
  RESULTS
  Of the 297 patients, 57 (19.2%) patients with bleeding after EMR were confirmed. With multivariate adjustment, the cutting method of EMR, diameter, and endoscopic pattern of the tumor were associated with the risk of bleeding after EMR. The multivariate-adjusted OR for bleeding after EMR using endoscopic aspiration mucosectomy was 3.07 (95%CI, 1.59-5.92) compared with strip biopsy. The multiple-adjusted OR for bleeding after EMR for the highest quartile (16-50 mm) of tumor diameter was 5.63 (95%CI, 1.84-17.23) compared with that for the lowest (4-7 mm). The multiple-adjusted OR for bleeding after EMR for depressed type of tumor was 4.21 (95%CI, 1.75-10.10) compared with elevated type.
  
  
  CONCLUSIONS
  It is important to take tumor characteristics (tumor size and endoscopic pattern) and cutting method of EMR into consideration in predicting bleeding after EMR.
authors.affiliation: Department of Gastroenterology, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Shiba
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
authors.forename: Kaori
authors.initials: K
authors.lastname: Kadouchi
authors.forename: Ai
authors.initials: A
authors.lastname: Montani
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamamori
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Okazaki
authors.forename: Makiko
authors.initials: M
authors.lastname: Taguchi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Wada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Itani
authors.forename: Toshio
authors.initials: T
authors.lastname: Watanabe
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tominaga
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Tomoshige
authors.initials: T
authors.lastname: Hayashi
authors.forename: Kei
authors.initials: K
authors.lastname: Tsumura
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Arakawa
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D005753:Gastric Mucosa / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D015999:Multivariate Analysis; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery