RT Journal Article
T1 A Scoring System to Determine Risk of Delayed Bleeding After Endoscopic Mucosal Resection of Large Colorectal Lesions.
A1 Albéniz, Eduardo
A1 Fraile, María
A1 Ibáñez, Berta
A1 Alonso-Aguirre, Pedro
A1 Martínez-Ares, David
A1 Soto, Santiago
A1 Gargallo, Carla Jerusalén
A1 Ramos Zabala, Felipe
A1 Álvarez, Marco Antonio
A1 Rodríguez-Sánchez, Joaquín
A1 Múgica, Fernando
A1 Nogales, Óscar
A1 Herreros de Tejada, Alberto
A1 Redondo, Eduardo
A1 Pin, Noel
A1 León-Brito, Helena
A1 Pardeiro, Remedios
A1 López-Roses, Leopoldo
A1 Rodríguez-Téllez, Manuel
A1 Jiménez, Alejandra
A1 Martínez-Alcalá, Felipe
A1 García, Orlando
A1 de la Peña, Joaquín
A1 Ono, Akiko
A1 Alberca de Las Parras, Fernando
A1 Pellisé, María
A1 Rivero, Liseth
A1 Saperas, Esteban
A1 Pérez-Roldán, Francisco
A1 Pueyo Royo, Antonio
A1 Eguaras Ros, Javier
A1 Zúñiga Ripa, Alba
A1 Concepción-Martín, Mar
A1 Huelin-Álvarez, Patricia
A1 Colán-Hernández, Juan
A1 Cubiella, Joaquín
A1 Remedios, David
A1 Bessa I Caserras, Xavier
A1 López-Viedma, Bartolomé
A1 Cobian, Julyssa
A1 González-Haba, Mariano
A1 Santiago, José
A1 Martínez-Cara, Juan Gabriel
A1 Valdivielso, Eduardo
A1 Guarner-Argente, Carlos
A1 Endoscopic Mucosal Resection Endoscopic Spanish Society Group, 
K1 ASA
K1 Colon Cancer
K1 Mucosectomy
K1 Prognostic Factor
AB 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.
YR 2016
FD 2016-03-24
LK http://hdl.handle.net/10668/9964
UL http://hdl.handle.net/10668/9964
LA en
DS RISalud
RD Apr 7, 2025