title: Incidence and predictors of postpolypectomy bleeding in colorectal polyps larger than 10 mm.
abstract: BACKGROUND
  It is well-established that the risk of postpolypectomy bleeding (PPB) increases with polyp size, but little is known about the factors that predict PPB in polyps larger than 10 mm.
  
  
  OBJECTIVE
  The aim of this study is to assess the incidence and risk factors for PPB in colorectal polyps larger than 10 mm.
  
  
  METHODS
  A historical cohort study was carried out in an open access endoscopy unit from January 2007 to December 2008. Endoscopic polypectomy was performed in 1894 (28%) patients. Clinical records of patients with polyps of at least 10 mm were reviewed. Data on demographics, comorbidity, polyp-related features, and resection technique were collected. The incidence of immediate bleeding (during polypectomy) and delayed bleeding (up to 1 month later) was assessed.
  
  
  RESULTS
  A total of 424 large polyps (median size=12 mm; P₂₅-P₇₅: 10-16 mm) were resected. Thirty-five episodes of PPB occurred in 33 (7.8%) polyps, of which 12 (2.8%) were delayed. Multivariate logistic regression analysis demonstrated that a polyp size of at least 14 mm was the most important predictor of PPB [odds ratio (OR) 3.17, 95% confidence interval (CI) 1.492-6.751, P=0.003], compared with the presence of a villous architecture (OR 2.23, 95% CI 1.056-4.705, P=0.035) or high-grade dysplasia (OR 2.96, 95% CI 1.305-6.692, P=0.009).
  
  
  CONCLUSIONS
  In the current study, the rate of PPB was almost 8% in polyps larger than 10 mm, occurring in most cases during the endoscopic procedure. A polyp of size at least 14 mm was the most important predictor for PPB. Prospective studies are needed to determine whether preventive endoscopic therapy may reduce PPB in these patients.
authors.affiliation: Research Unit, University Hospital of Canary Islands, La Laguna, Tenerife, Spain.
authors.forename: Antonio Z
authors.initials: AZ
authors.lastname: Gimeno-García
authors.forename: Zaida Adrián
authors.initials: ZA
authors.lastname: de Ganzo
authors.forename: Alejandro Jiménez
authors.initials: AJ
authors.lastname: Sosa
authors.forename: David Nicolás
authors.initials: DN
authors.lastname: Pérez
authors.forename: Enrique
authors.initials: E
authors.lastname: Quintero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult