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

BMC Gastroenterol. 2024 May 14;24(1):162. doi: 10.1186/s12876-024-03251-6.

Abstract

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 I2 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 I2 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.

Keywords: Colorectal polyps; Meta-analysis; Postoperative bleeding; Risk factors.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Colonic Polyps* / pathology
  • Colonic Polyps* / surgery
  • Colonoscopy
  • Endoscopic Mucosal Resection / adverse effects
  • Female
  • Humans
  • Hypertension* / complications
  • Incidence
  • Male
  • Postoperative Hemorrhage* / epidemiology
  • Postoperative Hemorrhage* / etiology
  • Risk Factors
  • Sex Factors