title: Assessment of risk factors for delayed colonic post-polypectomy hemorrhage: a study of 15553 polypectomies from 2005 to 2013.
abstract: OBJECTIVE
  Delayed colonic postpolypectomy bleeding is the commonest serious complication after polypectomy. This study aimed to utilize massive sampling data of polypectomy to analyze risk factors for delayed postpolypectomy bleeding.
  
  
  METHODS
  The endoscopic data of 5600 patients with 15553 polyps removed (2005 to 2013) were analyzed retrospectively through univariate analysis and multiple logistic regression analysis to evaluate the risk factors for delayed bleeding.
  
  
  RESULTS
  Delayed postpolypectomy bleeding occurred in 99 polyps (0.6%). The rates of bleeding for different polypectomy methods including hot biopsy forcep, biopsy forcep, Argon Plasma Coagulation (APC), Endoscopy piecemeal mucosal resection (EPMR), Endoscopic Mucosal Resection (EMR), and snare polypectomy were 0.1%, 0.0%, 0.0%, 6.9%, 0.9% and 1.0%, respectively. The risk factors for delayed bleeding were the size of polyps over 10 mm (odds ratio [OR] = 4.6, 95% CI, 2.9-7.2), pathology of colonic polyps (inflammatory/hyperplastic, OR = 1; adenomatous, OR = 1.4, 95% CI, 0.7-2.6; serrated, OR = 1.5, 95% CI, 0.2-11.9; juvenile, OR = 4.3, 95% CI, 1.8-11.0; Peutz-Jegher, OR = 3.3, 95% CI, 1.0-10.7), and immediate postpolypectomy bleeding (OR = 2.9, 95% CI, 1.4-5.9). In addition, although polypectomy method was not a risk factor, compared with hot biopsy forcep, snare polypectomy, EMR, and EPMR had increased risks of delayed bleeding, with ORs of 3.2 (0.4-23.3), 2.8 (0.4-21.7) and 5.1 (0.5-47.7), respectively.
  
  
  CONCLUSIONS
  Polyp size over 10 mm, pathology of colonic polyps (especially juvenile, Peutz-Jegher), and immediate postpolypectomy bleeding were significant risk factors for delayed postpolypectomy bleeding.
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southen Medical University, Guangzhou, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Bio-Statistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China.
authors.forename: Sheng li
authors.initials: Sl
authors.lastname: An
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southen Medical University, Guangzhou, China.
authors.forename: Zhen yu
authors.initials: Zy
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southen Medical University, Guangzhou, China.
authors.forename: Feng-Hua
authors.initials: FH
authors.lastname: Fu
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southen Medical University, Guangzhou, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southen Medical University, Guangzhou, China.
authors.forename: Fa chao
authors.initials: Fc
authors.lastname: Zhi
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southen Medical University, Guangzhou, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southen Medical University, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gong
mesh_terms: D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D013997:Time Factors