Prediction of immediate bleeding after cold snare polypectomy: A prospective observational study

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Device Technology

Background:

• Immediate post-polypectomy bleeding (IPPB) following cold snare polypectomy (CSP) is a recognized complication.
• Risk factors contributing to IPPB after CSP are not fully elucidated.
• Accurate prediction of IPPB is crucial for patient safety and procedural planning.

Purpose of the Study:

• To identify risk factors associated with immediate post-polypectomy bleeding (IPPB) after cold snare polypectomy (CSP).
• To develop and validate a predictive risk-scoring model for IPPB.
• To improve patient outcomes by enabling proactive risk assessment.

Main Methods:

• Prospective observational study involving 161 polyps (4-9 mm) removed via CSP from 118 patients.
• IPPB defined as bleeding within 24 hours or intraprocedural bleeding requiring hemostasis.
• Multivariate analysis to identify significant predictors; development of a four-marker risk-scoring model.

Main Results:

• Polyp size (6-9 mm vs 4-5 mm, OR 3.72), polyp morphology (polypoid vs non-polypoid, OR 3.93), and iatrogenic ulcer size (≥10 mm vs ≤9 mm, OR 3.12) were significantly associated with IPPB.
• A four-marker risk-scoring model was developed.
• The model demonstrated good predictive performance with sensitivity and specificity varying by cutoff point (e.g., cutoff of 3: 65% sensitivity, 90% specificity).

Conclusions:

• Polyp size and morphology, along with iatrogenic ulcer size and shape, are key factors influencing IPPB risk after CSP.
• The developed four-marker risk-scoring model offers an effective tool for predicting IPPB.
• This model can aid clinicians in assessing and managing bleeding risks associated with CSP.