Establishment of a model for predicting delayed post-polypectomy bleeding: A real-world retrospective study

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Delayed post-polypectomy bleeding (DPPB) is the most frequent complication following colonoscopic polypectomy.
• The increasing prevalence of colorectal cancer screening has led to a rise in polypectomy procedures and associated DPPB.
• Identifying predictors of DPPB is crucial for managing patients undergoing polypectomy.

Purpose of the Study:

• To identify independent predictors of delayed post-polypectomy bleeding (DPPB).
• To develop and validate a predictive model for DPPB risk assessment.
• To aid in identifying high-risk patients for closer monitoring after polypectomy.

Main Methods:

• Retrospective analysis of medical records from 16,925 patients who underwent colonoscopic polypectomy.
• Utilized LASSO-Logistic regression analysis to identify independent risk factors for DPPB.
• Developed a predictive nomogram integrating identified risk factors for DPPB risk stratification.

Main Results:

• DPPB occurred in 0.74% (125/16,925) of patients.
• Independent predictors of DPPB included young age, male sex, hypertension, polyp size (≥ 1 cm), proximal colon location, and operative modality.
• The developed nomogram demonstrated good predictive performance with a C-index of 0.801.

Conclusions:

• Young age, male sex, hypertension, large polyps (≥ 1 cm), proximal colon location, and operative modality are significant predictors of DPPB.
• A validated nomogram effectively predicts DPPB incidence.
• The established model serves as a valuable tool for identifying patients at high risk of post-polypectomy bleeding.