Risk factors and prediction model for delayed bleeding after cold snare polypectomy: a retrospective study

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Clinical Risk Prediction

Background:

• Delayed bleeding (DB) is a significant complication following colorectal polyp removal using cold snare polypectomy (CSP).
• Identifying patients at risk for DB is crucial for improving post-procedure outcomes.

Purpose of the Study:

• To determine the incidence and identify risk factors associated with delayed bleeding (DB) after colorectal cold snare polypectomy (CSP).
• To develop and validate a predictive risk-scoring model for DB post-CSP.

Main Methods:

• Retrospective analysis of 10,650 patients undergoing CSP across four medical institutions.
• Multivariate Cox regression analysis to identify DB risk factors and build a prediction model.
• Model validation using Kaplan-Meier analysis and ROC curves (AUCs ranging from 0.912 to 0.939).

Main Results:

• The incidence of DB after CSP was found to be 0.24%.
• Identified risk factors include hypertension, hyperlipidemia, antithrombotic/antiplatelet/anticoagulant use, prior abdominal surgery, sigmoid colon location, hematoma, snare defect, polyp/wound size, bleeding grade, and polyp morphology.
• The developed prediction model demonstrated high accuracy in predicting DB risk.

Conclusions:

• This study successfully identified key risk factors for delayed bleeding after colorectal cold snare polypectomy.
• A validated prediction model was established, offering a tool to help clinicians prevent and reduce DB rates following CSP.