Risk factors and prediction model for delayed bleeding after cold snare polypectomy: a retrospective study

TL;DR

This study identifies risk factors for delayed bleeding after a colon procedure called cold snare polypectomy and creates a prediction model to help reduce complications.

Contribution

The study introduces a novel risk-scoring model for predicting delayed bleeding after cold snare polypectomy based on multiple clinical and polyp-related factors.

Findings

A 0.24% incidence of delayed bleeding was observed after cold snare polypectomy.

The prediction model achieved high AUC values (0.912–0.939) for predicting delayed bleeding at different time points.

High-risk patients had significantly higher delayed bleeding rates compared to low-risk patients based on Kaplan–Meier analysis.

Abstract

Delayed bleeding (DB) is a serious complication after cold snare polypectomy (CSP) for polyps in the colon. The present study aimed to investigate the incidence and risk factors of DB after CSP and to develop a risk-scoring model for predicting DB.

A retrospective study was conducted in four Chinese medical institutions. 10650 patients underwent CSP from June 2019 to May 2023. The study analyzed the rate of DB and extracted the general clinical information and polyp-related information of patients with postoperative DB. As a control, non-DB patients who received CSP at the same 4 hospitals were analyzed. A multivariate Cox regression analysis was performed to develop the prediction model. The model was further validated using a Kaplan–Meier log-rank analysis, receiver operating characteristic curve (ROC) plot and risk plot.

In our study, we found a 0.24% rate of DB and the risk factors were history of hypertension, hyperlipidemia, antithrombotics use, antiplatelet use, anticoagulant use, abdominal operation, sigmoid colon lesion, hematoma, cold snare defect protrusion, polyp size, wound size, the grade of wound bleeding, and morphology of Ip. These factors were incorporated into the prediction model for DB after CSP. For 1, 3, and 5 days of bleeding, the AUC of the ROC curve was 0.912, 0.939, and 0.923, respectively. The Kaplan–Meier analysis indicated that the high-risk group had a significantly higher risk of DB than the low-risk group.

This study screened the risk factors and established a prediction model of DB after CSP. The results may help preventing and reducing the DB rate after CSP of colorectal polyps.

The online version contains supplementary material available at 10.1007/s00384-024-04687-8.

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