Journals / Turkish Journal of Gastroenterology / 2021 / Cilt: 32 - Sayı: 9

Nomogram for the Prediction of Delayed Colorectal Post-Polypectomy Bleeding

Pages
727–734
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: This predictive model may enable clinicians to predict the risk of delayed PPB and optimize preoperative decision-making, for effective treatment.

📌 3 Key Takeaways

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Objective & Hypothesis:Background: Delayed colorectal post-polypectomy bleeding (PPB) is a fairly common complication after polypectomy.
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Key Findings & Data:Methods: A cohort of 2494 patients who had undergone colonoscopic polypectomy between January 2016 and April 2020 were consecutively enrolled.
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Conclusion & Impact:Conclusion: This predictive model may enable clinicians to predict the risk of delayed PPB and optimize preoperative decision-making, for effective treatment.
🔬Design:Modeling & Simulation
📍Scope:2016 Verileri
⚙️Variables:Domain Parameters

Özet

Background: Delayed colorectal post-polypectomy bleeding (PPB) is a fairly common complication after polypectomy. The present study aimed to build a novel nomogram-based model of delayed PPB. Methods: A cohort of 2494 patients who had undergone colonoscopic polypectomy between January 2016 and April 2020 were consecutively enrolled. The patient demographics, polyp characteristics, laboratory factors, and pathological parameters were collected. The least absolute shrinkage and selection operator (LASSO) regression was applied for selecting potential variables. Multivariate logistic regression was used to develop the nomogram. A bootstrapping method was employed for internal validation. The performance of the nomogram was evaluated on the basis of its calibration, discrimination, and clinical usefulness. Results: Of 2494 patients undergoing colonoscopic polypectomy, 40 (1.6%) developed delayed PPB. The LASSO regression identified 6 variables (age, gender, polyp location, polyp morphology, antithrombotic medication use, and modality of polypectomy), and a predictive model was subsequently established. The area under the curve (AUC) of the predictive model and the internal validation were 0.838 (95% CI: 0.775-0.900) and 0.824 (95% CI: 0.759-0.889), respectively. The predictive model provided acceptable calibration, and a decision curve analysis (DCA) showed its clinical utility. Conclusion: This predictive model may enable clinicians to predict the risk of delayed PPB and optimize preoperative decision-making, for effective treatment.

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Cite This Article

HUAI, J., YE, X., DING, J. (2021). Nomogram for the Prediction of Delayed Colorectal Post-Polypectomy Bleeding. Turkish Journal of Gastroenterology, Cilt: 32 - Sayı: 9, 727–734. https://ajindex.com/articles/409181

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References (13)

  1. Gutta A, Gromski MA. Endoscopic management of post-polypectomy bleeding. Clin Endosc. 2020
  2. 53(3):302-310. [CrossRef] 2. Lin OS, Kozarek RA, Cha JM. Impact of sigmoidoscopy and colonoscopy on colorectal cancer incidence and mortality: An evidencebased review of published prospective and retrospective studies. Intest Res. 2014
  3. 12(4):268-274. [CrossRef] 3. Park SK, Seo JY, Lee MG, et al. Prospective analysis of delayed colorectal post-polypectomy bleeding. Surg Endosc. 2018
  4. 32(7):3282- 3289. [CrossRef] 4. Kwon MJ, Kim YS, Bae SI, et al. Risk factors for delayed post-polypectomy bleeding. Intest Res. 2015
  5. 13(2):160-165. [CrossRef] 5. Luigiano C, Consolo P, Scaffidi MG, et al. Endoscopic mucosal resection for large and giant sessile and flat colorectal polyps: A single-center experience with long-term follow-up. Endoscopy. 2009
  6. 41(10):829-835. [CrossRef] 6. Choung BS, Kim SH, Ahn DS, et al. Incidence and risk factors of delayed postpolypectomy bleeding: A retrospective cohort study. J Clin Gastroenterol. 2014
  7. 48(9):784-789. [CrossRef] 7. Wu XR, Church JM, Jarrar A, Liang J, Kalady MF. Risk factors for delayed postpolypectomy bleeding: How to minimize your patients’ risk. Int J Colorectal Dis. 2013
  8. 28(8):1127-1134. [CrossRef] 8. Liu C, Wu R, Sun X, Tao C, Liu Z. Risk factors for delayed hemorrhage after colonoscopic postpolypectomy: Polyp size and operative modality. JGH Open. 2019
  9. 3(1):61-64. [CrossRef] 9. Zhang Q, An Sl, Chen Zy, et al. Assessment of risk factors for delayed colonic post-polypectomy hemorrhage: A study of 15553 polypectomies from 2005 to 2013. PLOS ONE. 2014
  10. 9(10):e108290. [CrossRef] 10. Watabe H, Yamaji Y, Okamoto M, et al. Risk assessment for delayed hemorrhagic complication of colonic polypectomy: Polyprelated factors and patient-related factors. Gastrointest Endosc. 2006
  11. 64(1):73-78. [CrossRef] 11. Heldwein W, Dollhopf M, Rösch T, et al. The Munich Polypectomy Study (MUPS): prospective analysis of complications and risk factors in 4000 colonic snare polypectomies. Endoscopy. 2005
  12. 37(11):1116- 1122. [CrossRef] 12. Kim JH, Lee HJ, Ahn JW, et al. Risk factors for delayed post-polypectomy hemorrhage: a case-control study. J Gastroenterol Hepatol. 2013
  13. 28(4):645-649. [CrossRef] 13. Veitch AM, Vanbiervliet G, Gershlick AH, et al. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Gu