Risk Factors Associated With Postendoscopic Mucosal Resection Bleeding in Patients With Cirrhosis: A Retrospective Multicenter Cohort Study.

Autor:	Hasan B; Department of Gastroenterology, Cleveland Clinic Florida, Weston., Colak Y; Department of Gastroenterology, Cleveland Clinic Florida, Weston., Rashid MU; Department of Internal Medicine, Advent Heath Orlando, Orlando, FL., Van A; Department of Gastroenterology, Cleveland Clinic Florida, Weston., Sarvepalli D; Department of Internal Medicine, Advent Heath Orlando, Orlando, FL., Khalid RA; Department of Gastroenterology, Cleveland Clinic Florida, Weston., Yim Y; Department of Gastroenterology, Cleveland Clinic Florida, Weston., Rahman AU; Department of Gastroenterology, Cleveland Clinic Florida, Weston., Charles G; Department of Gastroenterology, Cleveland Clinic Florida, Weston., Castro FJ; Department of Gastroenterology, Cleveland Clinic Florida, Weston., Zervos XB; Department of Gastroenterology, Cleveland Clinic Florida, Weston., AlKhalloufi K; Department of Gastroenterology, Cleveland Clinic Florida, Weston.
Jazyk:	angličtina
Zdroj:	Journal of clinical gastroenterology [J Clin Gastroenterol] 2021 Apr 01; Vol. 55 (4), pp. 355-360.
DOI:	10.1097/MCG.0000000000001407
Abstrakt:	Background and Aim: There is limited data regarding the safety of endoscopic mucosal resection (EMR) in the cirrhotic population. Our study aimed to evaluate the safety of colonoscopic EMR in cirrhosis. Materials and Methods: This was a retrospective review of cirrhotics who underwent colonic EMR at 8 Cleveland Clinic Centers between January 1, 2006, and December 31, 2018. Patient data including polyp details and complications occurring within 30 days of the procedure were noted. Univariable and multivariable logistic regression analyses were conducted to find risk factors for post-EMR bleeding. Results: A total of 238 patients who underwent EMR were included. There were 145 males (60.9%) and the mean age was 61.9±8.6 years. Immediate and delayed bleeding, and postpolypectomy syndrome rates were 9.2%, 5.8%, and 1.3%, respectively. Significant risk factors for postpolypectomy bleeding were: increased age (P=0.001), procedure duration >37 minutes (P=0.001), antiplatelet use within 5 days (P=0.023), and lesion diameter >15 mm (P=0.004). Multivariable analysis revealed independent predictors of procedure-related bleeding: age above 65 years [odds ratio (OR) 2.14, P=0.044], antiplatelet use within 5 days (OR 2.42, P=0.047), right colon polyp (OR 3.51, P=0.001), and lesion diameter >15 mm (OR 3.22, P=0.003). Conclusions: EMR in cirrhotics has an acceptable bleeding risk. Age above 65 years, right colon polyp, polyp size >15 mm, and use of antiplatelets within 5 days are independent risk factors for bleeding. (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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