Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study.
OBJECTIVE
The aims of this prospective study were to document the incidence of colon immediate postpolypectomy bleeding (IPPB) according to grade, and to identify potential risk factors of IPPB in patients who have received complete colonoscopy and polypectomy because of a colorectal polyp.


METHODS
This was a prospective, cross-sectional study of 5,152 patients treated at 11 tertiary medical centers between July 2003 and July 2004. Patient-related, polyp-related, and procedure-related variables were evaluated as potential risk factors for IPPB. IPPB was defined as a bleeding occurring during the procedure and was graded as G1-G4. Risk factors associated with IPPB were analyzed by univariate and multivariate logistic regression analysis.


RESULTS
A total of 9,336 colonic polyps were removed in 5,152 patients, and 262 (2.8%) colorectal polyps in 215 patients presented with IPPB. Polyp-based multivariate analysis revealed that old age (>or=65 yr), comorbid cardiovascular or chronic renal disease, anticoagulant use, polyp size greater than 1 cm, gross morphology of polyps such as pedunculated polyp or laterally spreading tumor, poorer bowel preparation, cutting mode of the electrosurgical current, and the inadvertent cutting of a polyp before current application were significant risk factors for IPPB.


CONCLUSIONS
Nine factors have been found to be associated with IPPB and polypectomy should be undertaken with caution under these conditions.
Kim
Hyun S
HS
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Kim
Tae I
TI
Kim
Won H
WH
Kim
Young-Ho
YH
Kim
Hyo J
HJ
Yang
Suk-Kyun
SK
Myung
Seung-Jae
SJ
Byeon
Jeong-Sik
JS
Lee
Moon S
MS
Chung
Il K
IK
Jung
Sung-Ae
SA
Jeen
Yoon T
YT
Choi
Jai H
JH
Choi
Kyu Y
KY
Choi
Hwang
H
Han
Dong S
DS
Song
Jae S
JS
D000368:Aged; D016009:Chi-Square Distribution; D003111:Colonic Polyps / Q000175:diagnosis* / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors