Risk Factors For Delayed Bleeding After Endoscopic Mucosal Resection Of Colorectal Polyp

ObjectiveBleeding is the most common complication after colonoscopic polypectomy.According to whether bleeding occurred after endoscopic mucosal resection(EMR),these patients were divided into bleeding group and non-bleeding group.We have found out the independent risk factors of delayed bleeding,by comparing the clinical data,polyp characteristics and laboratory examination indicators.Providing a reference for early prevention and reasonable treatment to reduce the risk of delayed postpolypectomy bleeding(DPPB).MethodTotal 825 patients underwent colonoscopy polypectomy in the Second Hospital Affiliated to Soochow University from September 2017 to September 2019 were involved in this study.According to whether bleeding occurred after endoscopic mucosal resection,these patients were divided into two groups.We had collected all the patients' clinical datas and recorded them on the Microsoft Excel 2019 for Windows to establish a database.Logistic regression analysis was applied to deduce the independent risk factors for DPPB.The areas under the curve were calculated to investigate these independent risk factors in the diagnosis of delayed postpolypectomy bleeding.Result1.According to the inclusive criteria,a total of 33 in 825 colorectal polyps patients presented with delayed bleeding and the incidence of DPPB was 4%.Most of the patients in the bleeding group occurred symptoms within 3 days after operation,and the latest case occurred on the 5th day.All the patients had stanched bleeding successfully,of which eleven were treated by endoscopy.2.Univariate analysis indicated that PLT,age,hypertension,intraoperative bleeding,polyp location,size,morphology and pathology(P<0.05)were probable risk factors for DPPB.3.Multivariate logistic analysis indicated that PLT(P=0.001,OR=0.989,95%CI:0.982?0.995),hypertension(P=0.005,OR=3.181,95%CI:1.430?7.075),intraoperative bleeding(P<0.001,OR=57.274,95%CI:18.509?177.229)and polyp size(P=0.008,OR=3.084,95%CI:1.345?7.074)were independently associated with DPPB.The areas under curve of PLT,hypertension,intraoperative bleeding,a polyp size over 10 mm and combination were 0.641,0.610,0.645,0.612 and 0.828.Conclusion1.PLT,age,hypertension,intraoperative bleeding,polyp location,size,morphology and pathology were the impact factors of delayed bleeding after endoscopic mucosal resection.Among them,hypertension,intraoperative bleeding and a polyp size over 10 mm were the independent risk factors,PLT was a protective factor.2.Compared with all the individual factors,the combination can determine the incidence of delayed bleeding after endoscopic mucosal resection of colorectal polyps more effectively.