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Risk factors for delayed colonic post-polypectomy bleeding: a systematic review and meta-analysis

Veeravich Jaruvongvanich1,2, Narut Prasitlumkum2, Buravej Assavapongpaiboon2

  • 1Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA.

International Journal of Colorectal Disease
|August 6, 2017
PubMed
Abstract

Insights

Delayed post-polypectomy bleeding (PPB) risk factors include cardiovascular disease, hypertension, large polyps, and right-sided colon location. These findings aid in managing patients undergoing colonoscopic polypectomy.

Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Clinical Epidemiology

Background:

  • Delayed post-polypectomy bleeding (PPB) is a rare but significant complication following colonoscopic polypectomy.
  • Identifying reliable risk factors for delayed PPB is crucial for patient safety and management.
  • Previous studies have yielded inconsistent results regarding PPB risk factors.

Purpose of the Study:

  • To conduct a meta-analysis to identify significant risk factors associated with delayed post-polypectomy bleeding.
  • To consolidate evidence from multiple studies to provide a clearer understanding of PPB predictors.

Main Methods:

  • A systematic literature search was performed on MEDLINE and EMBASE databases up to January 2016.
  • Included studies investigated risk factors for delayed PPB.
  • Pooled odds ratios and mean differences were calculated using a random-effect model, with heterogeneity assessed by Q statistic and I-squared.

Main Results:

  • Twelve studies comprising 14,313 patients were analyzed.
  • The overall pooled rate of delayed PPB was 1.5%.
  • Significant risk factors identified were cardiovascular disease (OR=1.55), hypertension (OR=1.53), polyp size >10 mm (OR=3.41), and right colon polyp location (OR=1.60).

Conclusions:

  • Cardiovascular disease, hypertension, larger polyp size, and right-sided colon location are associated with an increased risk of delayed PPB.
  • Increased vigilance is recommended when performing polypectomies in patients with these identified risk factors.
  • Further research is needed to establish optimal preventive hemostatic strategies for high-risk patients.
Keywords:
BleedingColonoscopyMeta-analysisPolypectomyRisk factors

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