title: Clinical features of post-polypectomy bleeding associated with heparin bridge therapy.
abstract: BACKGROUND
  Heparin is given to patients undergoing colonoscopic polypectomy at high risk for thromboembolism. Little is known, however, about how heparin bridge therapy (HB) affects post-polypectomy bleeding (PPB). The present study aimed to identify the clinical features of PPB associated with HB.
  
  
  METHODS
  Data of consecutive inpatients who underwent colonoscopic polypectomy with antithrombotic therapy at Osaka University Hospital were retrospectively collected and categorized into a HB group or a non-HB group. The incidence and characteristics of PPB were analyzed.
  
  
  RESULTS
  A total of 117 patients with 279 lesions were identified, and the HB group included 45 patients. Nine of 10 patients with PPB were in the HB group, and the incidence of PPB was significantly higher in the HB group than in the non-HB group (20.0% vs 1.4%, respectively). PPB onset was later in the HB group than inthe non-HB group (median postoperative day: 4 vs 1, respectively). Five of the nine patients with PPB (55.6%) in the HB group experienced recurrent bleeding. One patient in the HB group required a blood transfusion as a result of massive PPB. All bleeding was eventually controlled endoscopically. Hospitalization was significantly longer in the HB group than in the non-HB group (median hospitalization: 14 vs 4 days, respectively). The univariate analysis showed that the predictors of PPB were warfarin use, HB and pedunculated polyps.
  
  
  CONCLUSIONS
  PPB associated with HB is characterized by high incidence, late onset and recurrent bleeding, resulting in long hospitalization.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Inoue
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishida
authors.forename: Akira
authors.initials: A
authors.lastname: Maekawa
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Tsujii
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Akasaka
authors.forename: Motohiko
authors.initials: M
authors.lastname: Kato
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Jumpei
authors.initials: J
authors.lastname: Kondo
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamada
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Shinzaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Iijima
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tsujii
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D003106:Colon / Q000601:surgery; D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay / Q000639:trends; D008297:Male; D019106:Postoperative Hemorrhage / Q000139:chemically induced*; D012189:Retrospective Studies; D013923:Thromboembolism / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: antithrombotic agent; bleeding; colonic polyp; endoscopic surgery; heparin