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A Scoring System to Determine Risk of Delayed Bleeding After Endoscopic Mucosal Resection of Large Colorectal Lesions
- Source :
- Clinical Gastroenterology and Hepatology, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname
- Publication Year :
- 2015
-
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
- 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
Subjects
Details
- ISSN :
- 15427714 and 15423565
- Volume :
- 14
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
- Accession number :
- edsair.doi.dedup.....e5e5d69b847f7ad587bb27e04a93e859