Risk factors for delayed post-polypectomy hemorrhage: a case-control study

J Gastroenterol Hepatol. 2013 Apr;28(4):645-9. doi: 10.1111/jgh.12132.


Background and aim: Delayed post-polypectomy hemorrhage is a rare but serious complication. The aim of this study was to identify risk factors for the development of delayed post-polypectomy hemorrhage.

Methods: This was a retrospective case-control study of patients who developed delayed hematochezia after receiving colonoscopic polypectomy. The control patients underwent uneventful polypectomy and were selected at a 4:1 ratio.

Results: Of the 7447 lesions examined from the 3253 patients who received colonoscopic polypectomy, 53 lesions (0.7%) of 42 patients (1.3%) developed delayed hemorrhage, and 168 patients were selected as controls. According to multivariate logistic regression analysis, a polyp larger than 10 mm (odds ratio [OR] 2.355, 95% confidence interval [CI] 1.225-4.528, P = 0.010), a pedunculated polyp (OR 3.473, 95% CI 1.576-7.657, P = 0.002), and a polyp located in the right hemi-colon (OR 2.690, 95% CI 1.465-4.940, P = 0.001) were significant risk factors for delayed post-polypectomy hemorrhage. The presence of comorbidities did not increase the risk of delayed hemorrhage.

Conclusion: Polyp size (large), shape (pedunculated), and location (right hemi-colon) represented substantial risk factors for the development of delayed hemorrhage after colonoscopic polypectomy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Case-Control Studies
  • Colonic Polyps / pathology
  • Colonic Polyps / surgery*
  • Colonoscopy*
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Medical Records
  • Middle Aged
  • Odds Ratio
  • Postoperative Hemorrhage / etiology*
  • Retrospective Studies
  • Risk Factors
  • Time Factors