Risk factors for delayed colorectal postpolypectomy bleeding: a meta-analysis

• Published in: BMC gastroenterology Vol. 24; no. 1; pp. 162 - 9
• Main Authors: Zhang, Xuzhen, Jiang, Xiaoxing, Shi, Liang
• Format: Journal Article
• Language: English
• Published: London BioMed Central 14.05.2024; BioMed Central Ltd; BMC
• Subjects: Anticoagulants; Anticoagulants - therapeutic use; Bleeding; Cardiovascular disease; Care and treatment; Cohort analysis; Colonic Polyps - pathology; Colonic Polyps - surgery; Colonoscopy; Colorectal diseases; Colorectal polyps; Diabetes; Diagnosis; Disease prevention; Endoscopic Mucosal Resection - adverse effects; Endoscopy; Evaluation; Female; Gastroenterology; Gastrointestinal diseases; Hepatology; Humans; Hypertension; Hypertension - complications; Incidence; Internal Medicine; Male; Medicine; Medicine & Public Health; Meta-analysis; Mortality; Mucosa; Patients; Polyps; Postoperative bleeding; Postoperative Hemorrhage - epidemiology; Postoperative Hemorrhage - etiology; Risk Factors; Sensitivity analysis; Sex Factors; Tumors; China; Colorectal polyps; Postoperative bleeding; Risk factors; Meta-analysis
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-024-03251-6

Background To systematically analyze risk factors for delayed postpolypectomy bleeding (DPPB) in colorectum. Methods We searched seven large databases from inception to July 2022 to identify studies that investigated risk factors for DPPB. The effect sizes were expressed by relative risk (RR) and 95% confidence interval (95% CI). The heterogeneity was analyzed by calculating I 2 values and performing sensitivity analyses. Results A total of 15 articles involving 24,074 subjects were included in the study. The incidence of DPPB was found to be 0.02% (95% CI, 0.01–0.03), with an I 2 value of 98%. Our analysis revealed that male sex (RR = 1.64), history of hypertension (RR = 1.54), anticoagulation (RR = 4.04), polyp size (RR = 1.19), polyp size ≥ 10 mm (RR = 2.43), polyp size > 10 mm (RR = 3.83), polyps located in the right semicolon (RR = 2.48) and endoscopic mucosal resection (RR = 2.99) were risk factors for DPPB. Conclusions Male sex, hypertension, anticoagulation, polyp size, polyp size ≥ 10 mm, polyps located in the right semicolon, and endoscopic mucosal resection were the risk factors for DPPB. Based on our findings, we recommend that endoscopists should fully consider and implement effective intervention measures to minimize the risk of DPPB.