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Postpolypectomy Fever, a rare adverse event of polypectomy: nested case-control study
Seung-Hoon Lee1, Kyung-Jo Kim1, Dong-Hoon Yang1
1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Background/Aims:
Although postpolypectomy fever (PPF) without colon perforation or hemorrhage is rare, its incidence and risk factors have not been investigated. The objective of this study was to analyze the incidence and risk factors for PPF among inpatients.
Methods:
Seven patients with PPF were matched with 70 patients without PPF from a total of 3,444 patients who underwent colonoscopic polypectomy. The PPF incidence during index hospitalization after colonoscopy was calculated, and univariate and multivariate analyses were performed to calculate the adjusted odds ratios (ORs) for risk factors.
Results:
PPF without bleeding or perforation in the colon occurred in seven patients (0.2%). The median age was 58 years for cases and 61 years for controls. The median interval from polypectomy to occurrence of fever was 7 hours, and the median duration of fever was 9 hours. Polyp size >2 cm (adjusted OR, 1.08; 95% confidence interval [CI], 1.01 to 1.15; p=0.02) and hypertension (adjusted OR, 14.40; 95% CI, 1.23 to 180.87; p=0.03) were associated with a significantly increased risk of PPF. PPF increased the length of hospitalization.
Conclusions:
Although the crude incidence of PPF is low, PPF may prolong hospitalization. Risk factors for PPF include hypertension and large polyps.
Insights
Postpolypectomy fever (PPF) is a rare complication after colonoscopy, occurring in 0.2% of patients. Hypertension and large polyps (>2 cm) are identified as key risk factors for developing PPF.
Area of Science:
- Gastroenterology
- Endoscopy
- Public Health
Background:
- Postpolypectomy fever (PPF) without complications like perforation or hemorrhage is uncommon.
- Limited data exists on the incidence and risk factors of PPF.
Purpose of the Study:
- To determine the incidence of PPF among inpatients undergoing colonoscopic polypectomy.
- To identify risk factors associated with PPF.
Main Methods:
- A case-control study involving 7 PPF patients matched with 70 controls from 3,444 patients.
- Univariate and multivariate analyses were used to identify risk factors and calculate adjusted odds ratios (ORs).
Main Results:
- The incidence of PPF was 0.2% (7 patients).
- Large polyps (>2 cm) and hypertension were significantly associated with increased PPF risk (adjusted ORs 1.08 and 14.40, respectively).
- PPF was linked to a prolonged hospital stay.
Conclusions:
- While PPF is rare, it can extend hospitalization duration.
- Hypertension and large polyp size are significant risk factors for PPF.
