A risk-scoring model for the prediction of delayed bleeding after colorectal endoscopic submucosal dissection.

A risk-scoring model for the prediction of delayed bleeding after colorectal endoscopic submucosal dissection.

Gastrointest Endosc. 2018 Dec 03;:

Authors: Seo M, Song EM, Cho JW, Lee YJ, Lee BI, Kim JS, Jeon SW, Jang HJ, Yang DH, Ye BD, Byeon JS

Abstract
BACKGROUND AND AIMS: Delayed bleeding is an important adverse event after colorectal endoscopic submucosal dissection (ESD). We aimed to investigate the incidence and risk factors of delayed bleeding after colorectal ESD, and to develop a risk scoring model for predicting delayed bleeding.
METHODS: This retrospective multicenter study was performed at 5 centers. The derivation and validation cohorts comprised 1189 patients from 1 center and 415 patients from the other 4 centers. We investigated the incidence and risk factors of delayed bleeding. Then, we developed a risk scoring model for predicting delayed bleeding using the data of the derivation cohort. We validated the scoring system in the validation cohort.
RESULTS: Delayed bleeding occurred in 34 (2.9%) patients in the derivation cohort. In multivariate analysis, the risk factors of delayed bleeding were tumor location in the rectosigmoid colon (odds ratio [OR], 6.49; 95% confidence interval [CI], 1.96-21.42; P=0.002), large tumor (≥30 mm; OR, 2.10; 95% CI, 1.01-4.40; P=0.048), and use of antiplatelet agents except for aspirin alone (OR, 4.04; 95% CI, 1.44-11.30; P=0.008). These 3 factors were incorporated into a risk scoring model for prediction of delayed bleeding. As the score based on this system increased, the incidence of delayed bleeding increased in the validation cohort.
CONCLUSIONS: The risk scoring model incorporating tumor location, tumor size, and use of antiplatelet agents can quantitatively predict the risk of delayed bleeding after colorectal ESD.

PMID: 30521794 [PubMed - as supplied by publisher]

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