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Optimal timing for resuming antithrombotic agents and risk factors for delayed bleeding after endoscopic resection of colorectal tumors.

Beppu K, Osada T, Sakamoto N, Shibuya T, Matsumoto K, Nagahara A, Terai T, Ogihara T, Watanabe S - Gastroenterol Res Pract (2014)

Bottom Line: By multivariate analysis resumption of anticoagulants within 5 days was a significant risk factor for delayed bleeding (OR 10.2; 95% CI = 2.7-38.3; P = 0.0006).Other patient- and tumor-factors were not significant.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.

ABSTRACT
Aim. To examine optimal timing for resuming antithrombotic agents and risk factors for delayed bleeding after endoscopic resection of colorectal tumors. Method. Of 1,970 polyps larger than 10 mm removed by polypectomy, endoscopic mucosal resection, or endoscopic submucosal dissection, delayed bleeding, which was designated as bleeding that occurred 6 or more hours after endoscopic treatment, occurred in 52 cases (2.6%); 156 nonbleeding cases matched for age and gender were controls in this single-institution retrospective case-control study. We investigated (1) patient-factors: resuming antithrombotic agents within 5 days following endoscopic resection, hypertension, and diabetes mellitus; and (2) tumor-factors: morphology, size, location, and resection technique by conditional logistic regression. Results. By multivariate analysis resumption of anticoagulants within 5 days was a significant risk factor for delayed bleeding (OR 10.2; 95% CI = 2.7-38.3; P = 0.0006). But resuming a thienopyridine within 5 days was not (OR 0.9; 95% CI = 0.1-2.6; P = 0.40). Other patient- and tumor-factors were not significant. Conclusion. Resuming anticoagulants within 5 days after endoscopic treatment was associated with delayed bleeding whereas resuming thienopyridines was not.

No MeSH data available.


Related in: MedlinePlus

Days from treatment to bleeding in cases who were and were not taking anticoagulants. Delayed bleeding occurred within 7 days in most cases (87%).
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4273557&req=5

fig2: Days from treatment to bleeding in cases who were and were not taking anticoagulants. Delayed bleeding occurred within 7 days in most cases (87%).

Mentions: Figure 2 shows the days from endoscopic treatment to delayed bleeding in cases who were and were not taking anticoagulants. Of the 52 bleeding cases, 12 were taking anticoagulants, which included 5 using heparin bridging therapy, and 40 were not taking anticoagulants. When examining all cases of delayed bleeding, the bleeding occurred within 7 days in most cases. In exploratory analysis, we compared the median days from endoscopic treatment to bleeding (Table 5). Anticoagulants were resumed within 3 days in 9 of 12 cases who had been taking anticoagulants and from3 to 5 days in the remaining 3 cases. The median days was significantly longer in cases taking anticoagulants than in those who were not (median = 4 days versus 2 days, P = 0.04).


Optimal timing for resuming antithrombotic agents and risk factors for delayed bleeding after endoscopic resection of colorectal tumors.

Beppu K, Osada T, Sakamoto N, Shibuya T, Matsumoto K, Nagahara A, Terai T, Ogihara T, Watanabe S - Gastroenterol Res Pract (2014)

Days from treatment to bleeding in cases who were and were not taking anticoagulants. Delayed bleeding occurred within 7 days in most cases (87%).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4273557&req=5

fig2: Days from treatment to bleeding in cases who were and were not taking anticoagulants. Delayed bleeding occurred within 7 days in most cases (87%).
Mentions: Figure 2 shows the days from endoscopic treatment to delayed bleeding in cases who were and were not taking anticoagulants. Of the 52 bleeding cases, 12 were taking anticoagulants, which included 5 using heparin bridging therapy, and 40 were not taking anticoagulants. When examining all cases of delayed bleeding, the bleeding occurred within 7 days in most cases. In exploratory analysis, we compared the median days from endoscopic treatment to bleeding (Table 5). Anticoagulants were resumed within 3 days in 9 of 12 cases who had been taking anticoagulants and from3 to 5 days in the remaining 3 cases. The median days was significantly longer in cases taking anticoagulants than in those who were not (median = 4 days versus 2 days, P = 0.04).

Bottom Line: By multivariate analysis resumption of anticoagulants within 5 days was a significant risk factor for delayed bleeding (OR 10.2; 95% CI = 2.7-38.3; P = 0.0006).Other patient- and tumor-factors were not significant.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.

ABSTRACT
Aim. To examine optimal timing for resuming antithrombotic agents and risk factors for delayed bleeding after endoscopic resection of colorectal tumors. Method. Of 1,970 polyps larger than 10 mm removed by polypectomy, endoscopic mucosal resection, or endoscopic submucosal dissection, delayed bleeding, which was designated as bleeding that occurred 6 or more hours after endoscopic treatment, occurred in 52 cases (2.6%); 156 nonbleeding cases matched for age and gender were controls in this single-institution retrospective case-control study. We investigated (1) patient-factors: resuming antithrombotic agents within 5 days following endoscopic resection, hypertension, and diabetes mellitus; and (2) tumor-factors: morphology, size, location, and resection technique by conditional logistic regression. Results. By multivariate analysis resumption of anticoagulants within 5 days was a significant risk factor for delayed bleeding (OR 10.2; 95% CI = 2.7-38.3; P = 0.0006). But resuming a thienopyridine within 5 days was not (OR 0.9; 95% CI = 0.1-2.6; P = 0.40). Other patient- and tumor-factors were not significant. Conclusion. Resuming anticoagulants within 5 days after endoscopic treatment was associated with delayed bleeding whereas resuming thienopyridines was not.

No MeSH data available.


Related in: MedlinePlus