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

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 10mm (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.