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Title: A Scoring System to Determine Risk of Delayed Bleeding After Endoscopic Mucosal Resection of Large Colorectal Lesions.
Authors: Albéniz, Eduardo
Fraile, María
Ibáñez, Berta
Alonso-Aguirre, Pedro
Martínez-Ares, David
Soto, Santiago
Gargallo, Carla Jerusalén
Ramos Zabala, Felipe
Álvarez, Marco Antonio
Rodríguez-Sánchez, Joaquín
Múgica, Fernando
Nogales, Óscar
Herreros de Tejada, Alberto
Redondo, Eduardo
Pin, Noel
León-Brito, Helena
Pardeiro, Remedios
López-Roses, Leopoldo
Rodríguez-Téllez, Manuel
Jiménez, Alejandra
Martínez-Alcalá, Felipe
García, Orlando
de la Peña, Joaquín
Ono, Akiko
Alberca de Las Parras, Fernando
Pellisé, María
Rivero, Liseth
Saperas, Esteban
Pérez-Roldán, Francisco
Pueyo Royo, Antonio
Eguaras Ros, Javier
Zúñiga Ripa, Alba
Concepción-Martín, Mar
Huelin-Álvarez, Patricia
Colán-Hernández, Juan
Cubiella, Joaquín
Remedios, David
Bessa I Caserras, Xavier
López-Viedma, Bartolomé
Cobian, Julyssa
González-Haba, Mariano
Santiago, José
Martínez-Cara, Juan Gabriel
Valdivielso, Eduardo
Guarner-Argente, Carlos
Endoscopic Mucosal Resection Endoscopic Spanish Society Group
Keywords: ASA;Colon Cancer;Mucosectomy;Prognostic Factor
metadata.dc.subject.mesh: Adult
Aged, 80 and over
Decision Support Techniques
Endoscopic Mucosal Resection
Gastrointestinal Hemorrhage
Middle Aged
Prospective Studies
Risk Assessment
Young Adult
Issue Date: 24-Mar-2016
Abstract: After endoscopic mucosal resection (EMR) of colorectal lesions, delayed bleeding is the most common serious complication, but there are no guidelines for its prevention. We aimed to identify risk factors associated with delayed bleeding that required medical attention after discharge until day 15 and develop a scoring system to identify patients at risk. We performed a prospective study of 1214 consecutive patients with nonpedunculated colorectal lesions 20 mm or larger treated by EMR (n = 1255) at 23 hospitals in Spain, from February 2013 through February 2015. Patients were examined 15 days after the procedure, and medical data were collected. We used the data to create a delayed bleeding scoring system, and assigned a weight to each risk factor based on the β parameter from multivariate logistic regression analysis. Patients were classified as being at low, average, or high risk for delayed bleeding. Delayed bleeding occurred in 46 cases (3.7%, 95% confidence interval, 2.7%-4.9%). In multivariate analysis, factors associated with delayed bleeding included age ≥75 years (odds ratio [OR], 2.36; P The risk of delayed bleeding after EMR of large colorectal lesions is 3.7%. We developed a risk scoring system based on 6 factors that determined the risk for delayed bleeding (receiver operating characteristic curve, 0.77). The factors most strongly associated with delayed bleeding were right-sided lesions, aspirin use, and mucosal defects not closed by hemoclips. Patients considered to be high risk (score, 8-10) had a 40% probability of delayed bleeding.
metadata.dc.identifier.doi: 10.1016/j.cgh.2016.03.021
Appears in Collections:Producción 2020

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