scholarly journals The effect of prophylactic hemoclip placement and risk factors of delayed post-polypectomy bleeding in polyps sized 6 to 20 millimeters: a propensity score matching analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chun-Wei Chen ◽  
Chia-Jung Kuo ◽  
Cheng-Tang Chiu ◽  
Ming-Yao Su ◽  
Chun-Jung Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Major Complication ◽  
Potential Bias ◽  
Polyp Size ◽  
Propensity Score Matching Analysis ◽  
History Of ◽  
Snare Polypectomy

Abstract Background Delayed post-polypectomy bleeding (PPB) is a major complication of polypectomy. The effect of prophylactic hemoclipping on delayed PPB is uncertain. The aim of this study was to evaluate the effectiveness of prophylactic hemoclipping and identify the risk factors of delayed PPB. Methods Patients with polyps sized 6 to 20 mm underwent snare polypectomy from 2015 to 2017 were retrospectively reviewed. The patients with prophylactic hemoclipping for delayed PPB prevention were included in the clipping group, and those without prophylactic hemoclipping were included in the non-clipping group. The incidence of delayed PPB and time to bleeding were compared between the groups. Multivariate analysis was used to identify the risk factors of delayed PPB. Propensity score matching was used to minimize potential bias. Results After propensity score matching, 612 patients with 806 polyps were in the clipping group, and 576 patients with 806 polyps were in the non-clipping group. There were no significant differences in the incidence of delayed PPB and days to bleeding between two groups (0.8% vs 1.3%, p = 0.4; 3.4 ± 1.94 days vs 4.13 ± 3.39 days, p = 0.94). In the multivariate analysis, the polyp size [Odds ratio (OR):1.16, 95% confidence interval (CI):1.01–1.16, p = 0.03), multiple polypectomies (OR: 4.64, 95% CI:1.24–17.44, p = 0.02) and a history of anticoagulant use (OR:37.52, 95% CI:6.49–216.8, p < 0.001) were associated with delayed PPB. Conclusions In polyps sized 6 to 20 mm, prophylactic hemoclip placement did not decrease the risk of delayed PPB. Patients without risk factors including multiple polypectomies and anticoagulant use are no need to performing prophylactic hemoclipping.

scholarly journals Cold snare polypectomy reduced delayed postpolypectomy bleeding compared with conventional hot polypectomy: a propensity score-matching analysis

2017 ◽  
Vol 05 (07) ◽  
pp. E587-E594 ◽  
Author(s):  
Takeshi Yamashina ◽  
Manabu Fukuhara ◽  
Takanori Maruo ◽  
Gensho Tanke ◽  
Saiko Marui ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Secondary Analysis ◽  
Colorectal Polyps ◽  
Propensity Score Model ◽  
Propensity Score Matching Analysis ◽  
Significant Difference ◽  
Cold Snare Polypectomy ◽  
Few Data ◽  
Snare Polypectomy

Abstract Background and study aims Cold snare polypectomy (CSP) for small colorectal polyps has lower incidence of adverse events, especially delayed postpolypectomy bleeding (DPPB). However, few data are available on comparisons of the incidence of DPPB of CSP and hot polypectomy (HP). The aim of this study was to evaluate the incidence of DPPB after CSP and compare it with that of HP. A propensity score model was used as a secondary analysis. Patients and methods This was a retrospective cohort study conducted in a single municipal hospital. We identified 539 patients with colorectal polyps from 2 mm to 11 mm in size who underwent CSP (804 polyps in 330 patients) or HP (530 polyps in 209 patients) between July 2013 and June 2015. Results There were no cases of DPPB in the CSP group. Conversely, DPPB occurred in 4 patients (1.9 %) after HP, resulting in a significant difference between the CSP and HP groups (0.008 % vs 0 %, P = 0.02). Propensity score-matching analysis created 402 matched pairs, yielding a significantly higher DPPB rate in the HP group than CSP group (0.02 % vs 0 %, P = 0.04). However, significantly more patients in the CSP group had unclear horizontal margins that precluded assessment (83 vs 38 cases, P < 0.001). The retrieval failure rate was significantly higher in the CSP group than in the HP group (3 % vs 0.7 %, P = 0.01). Conclusions DPPB was less frequent with CSP than HP, as selected by the propensity score-matching model. Our findings indicate that CSP is recommended polypectomy in daily clinical setting. However, special care should be taken during polyp retrieval and horizontal margin assessment, and these issues could be taken into account in follow-up after CSP.

scholarly journals The Outcome of Complex Hepato-Pancreato-Biliary Surgery for Elderly Patients: A Propensity Score Matching Analysis

2018 ◽  
Vol 36 (4) ◽  
pp. 323-330 ◽  
Author(s):  
Kosei Takagi ◽  
Yuzo Umeda ◽  
Ryuichi Yoshida ◽  
Daisuke Nobuoka ◽  
Takashi Kuise ◽  
...  
Keyword(s):  
Risk Factors ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Elderly Group ◽  
Postoperative Outcomes ◽  
Mortality And Morbidity ◽  
Propensity Score Matching Analysis

Background/Aims: Postoperative mortality and morbidity rates after hepato-pancreato-biliary (HPB) surgery remain high, and the number of elderly patients requiring such surgery has been increasing. This study aimed to investigate postoperative outcomes of complex HPB surgery for elderly patients. Methods: We retrospectively reviewed perioperative data of 721 patients who underwent complex HPB surgery between 2010 and 2015. The patients were divided into 2 groups: elderly (≥75 years) and non-elderly (< 75 years). Surgical outcomes of both groups were compared after propensity score-matching analysis. Subsequently, risk factors for serious postoperative morbidity were identified by multivariate analysis. Results: Before matching, the elderly group (n = 170) had more comorbidities, such as cardiovascular and renal disease, than the non-elderly group (n = 551). Matching yielded elderly (n = 170) and non-elderly groups (n = 170) with similar preoperative backgrounds. The mortality and morbidity rates did not differ significantly between the groups. In multivariate analyses, operative time (OR 1.79; p = 0.005) and blood loss (OR 1.66; p = 0.03) were identified as independent risk factors for serious postoperative morbidity, whereas older age did not have a predictive impact (OR 1.16; p = 0.52). Conclusions: Although elderly ­patients had more comorbidities and higher incidences of postoperative mortality and several complications before matching, their postoperative outcomes were equivalent to those of non-elderly patients after matching.

scholarly journals Relationship between tooth extraction and development of medication-related osteonecrosis of the jaw in cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sakiko Soutome ◽  
Mitsunobu Otsuru ◽  
Saki Hayashida ◽  
Maho Murata ◽  
Souichi Yanamoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Tooth Extraction ◽  
Patient Characteristics ◽  
Osteonecrosis Of The Jaw ◽  
Propensity Score Matching Analysis ◽  
Infection Source

AbstractTooth extraction has been avoided since it has been considered a major risk factor for medication-related osteonecrosis of the jaw (MRONJ). However, MRONJ may also develop from tooth that is an infection source. This study aimed to clarify whether tooth extraction is a risk factor for the development of MRONJ in cancer patients receiving bone-modifying agents (BMAs). This retrospective observational study included 189 patients (361 jaws) from two hospitals. The risk factors of MRONJ were identified by comparing patient characteristics between those who did and did not develop MRONJ. Furthermore, the effect of tooth extraction during BMA therapy was analyzed after adjusting for confounding factors using the propensity score matching method. MRONJ occurred in 33 patients jaws. A longer duration of BMA administration, fewer number of teeth, presence of symptoms of local infection, and infected teeth were independent risk factors of MRONJ. However, tooth extraction during BMA therapy did not increase the risk. Propensity score matching analysis showed that tooth extraction significantly lowered the risk of MRONJ development. Teeth that can be an infection source increases the risk of MRONJ, and thus, they need to be extracted even during BMA administration.

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