Risk of Gastrointestinal Endoscopic Procedure-Related Bleeding in Patients With or Without Continued Antithrombotic Therapy
| Autor: | Naoki Tanaka, Takahiro Kudo, Yasuyuki Ichise, Masashi Kajiyama, Ichitaro Horiuchi, Akira Horiuchi, Kiyoaki Yabe |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Physiology medicine.medical_treatment Colonoscopy Risk Assessment Endoscopy Gastrointestinal 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Japan Risk Factors Biopsy Antithrombotic Humans Medicine Prospective Studies Prospective cohort study Aged Aged 80 and over Univariate analysis medicine.diagnostic_test business.industry Esophagogastroduodenoscopy Gastroenterology Middle Aged medicine.disease Polypectomy Surgery Treatment Outcome 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Gastrointestinal Hemorrhage business Kidney disease |
| Zdroj: | Digestive Diseases and Sciences. 66:1548-1555 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-020-06393-1 |
| Popis: | Prospective studies on bleeding risk during/after gastrointestinal endoscopic procedures are rare. We investigated the risk of endoscopic procedure-related bleeding in patients with biopsy and/or cold snare polypectomy (CSP) in relation to antithrombotic therapy. This prospective, observational single-center cohort study (NCT02594813) enrolled consecutive patients who underwent diagnostic esophagogastroduodenoscopy (EGD) or colonoscopy. The primary outcome measure was delayed bleeding in patients with biopsy and/or CSP who required endoscopic treatment within 2 weeks post-procedure. The secondary outcomes were immediate bleeding and the number of hemostatic clips used during the procedure. From November 2015 to October 2018 at our institution, 3069 (mean age, 66 years) and 37,887 (57 years) patients underwent EGD with and without antithrombotic therapy, respectively. In addition, 1116 (72 years) and 11,901 (65 years) patients had colonoscopy with and without antithrombotic therapy, respectively. In the 3069 EGD patients receiving antithrombotic therapy, no delayed bleeding occurred, whereas immediate bleeding occurred in 9 of 141 patients (6.4%) with biopsy. Of the 1116 colonoscopy patients receiving antithrombotic therapy, delayed bleeding occurred in three of 228 (1.3%) following CSP. Immediate bleeding occurred in nine of 225 (4%) following biopsy and in 32 of 228 (14%) following CSP. Multivariate analysis following univariate analysis identified chronic kidney disease and CSP as factors significantly associated with procedure-related bleeding in patients taking antithrombotic agents. The risk of delayed bleeding in diagnostic EGD with biopsy or in colonoscopy with biopsy and/or CSP was low despite continuation of antithrombotic therapy. |
| Databáze: | OpenAIRE |
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