1. A Scoring System to Determine Risk of Delayed Bleeding After Endoscopic Mucosal Resection of Large Colorectal Lesions
- Author
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Albéniz, Eduardo, Fraile, María, Ibáñez, Berta, Alonso-Aguirre, Pedro, Martínez-Ares, David, Soto, Santiago, Gargallo, Carla Jerusalén, Ramos Zabala, Felipe, Álvarez, Marco Antonio, Rodríguez-Sánchez, Joaquín, Múgica, Fernando, Nogales, Óscar, Herreros de Tejada, Alberto, Redondo, Eduardo, Pin, Noel, León-Brito, Helena, Pardeiro, Remedios, López-Roses, Leopoldo, Rodríguez-Téllez, Manuel, Jiménez, Alejandra, Martínez-Alcalá, Felipe, García, Orlando, de la Peña, Joaquín, Ono, Akiko, Alberca de Las Parras, Fernando, Pellisé, María, Rivero, Liseth, Saperas, Esteban, Pérez-Roldán, Francisco, Pueyo Royo, Antonio, Eguaras Ros, Javier, Zúñiga Ripa, Alba, Concepción-Martín, Mar, Huelin-Álvarez, Patricia, Colán-Hernández, Juan, Cubiella, Joaquín, Remedios, David, Bessa I Caserras, Xavier, López-Viedma, Bartolomé, Cobian, Julyssa, González-Haba, Mariano, Santiago, José, Martínez-Cara, Juan Gabriel, Valdivielso, Eduardo, Guarner-Argente, Carlos, and Endoscopic Mucosal Resection Endoscopic Spanish Society Group
- Subjects
Adult ,Male ,medicine.medical_specialty ,ASA ,Mucosectomy ,Endoscopic Mucosal Resection ,Endoscopic mucosal resection ,Gastroenterology ,Risk Assessment ,Decision Support Techniques ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Risk factor ,Prospective cohort study ,Aged ,Aged, 80 and over ,Aspirin ,Hepatology ,Receiver operating characteristic ,Colon Cancer ,business.industry ,Prognostic Factor ,Odds ratio ,Middle Aged ,Confidence interval ,Surgery ,Spain ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,business ,Risk assessment ,Gastrointestinal Hemorrhage ,medicine.drug - Abstract
BACKGROUND & AIMS: After endoscopic mucosal resection (EMR) of colorectal lesions, delayed bleeding is the most common serious complication, but there are no guidelines for its prevention. We aimed to identify risk factors associated with delayed bleeding that required medical attention after discharge until day 15 and develop a scoring system to identify patients at risk. METHODS: We performed a prospective study of 1214 consecutive patients with nonpedunculated colorectal lesions 20 mm or larger treated by EMR (n = 1255) at 23 hospitals in Spain, from February 2013 through February 2015. Patients were examined 15 days after the procedure, and medical data were collected. We used the data to create a delayed bleeding scoring system, and assigned a weight to each risk factor based on the beta parameter from multivariate logistic regression analysis. Patients were classified as being at low, average, or high risk for delayed bleeding. RESULTS: Delayed bleeding occurred in 46 cases (3.7%, 95% confidence interval, 2.7%-4.9%). In multivariate analysis, factors associated with delayed bleeding included age >= 75 years (odds ratio [OR], 2.36; P= 40 mm (OR, 1.91; P
- Published
- 2015