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@ARTICLE{Xiao:285407,
      author       = {Q. Xiao and M. Eckardt and A. Mohamed and H. Ernst and A.
                      Behrens and N. Homann and T. Hielscher$^*$ and G. Kähler
                      and M. Ebert and S. Belle and T. Zhan},
      title        = {{O}nset time and characteristics of post-procedural
                      bleeding after endoscopic resection of colorectal lesions: a
                      multicenter retrospective study.},
      journal      = {Digestive diseases},
      volume       = {42},
      number       = {1},
      issn         = {0253-4398},
      address      = {Basel},
      publisher    = {Karger},
      reportid     = {DKFZ-2023-02363},
      pages        = {78-86},
      year         = {2024},
      note         = {2024;42(1):78-86},
      abstract     = {Introduction Postprocedural bleeding is a major adverse
                      event after endoscopic resection of colorectal lesions, but
                      the optimal surveillance time after endoscopy is unclear. In
                      this study, we determined onset time and characteristics of
                      postprocedural bleeding events. Methods We retrospectively
                      screened patients who underwent endoscopic resection of
                      colorectal lesions at three German hospitals between 2010
                      and 2019 for postprocedural bleeding events using billing
                      codes. Only patients who required re-endoscopy were included
                      for analysis. For identified patients, we collected
                      demographic data, clinical courses, characteristics of
                      colorectal lesions and procedure-related variables. Factors
                      associated with late-onset bleeding were determined by
                      univariate and multivariate logistic regression analysis.
                      Results From a total of 6820 patients with eligible billing
                      codes, we identified 113 cases with postprocedural bleeding
                      after endoscopic mucosal $(61.9\%)$ or snare resection
                      $(38.1\%)$ that required re-endoscopy. The median size of
                      the culprit lesion was 20 mm (interquartile range 14-30 mm).
                      The median onset time of postprocedural bleeding was day 3
                      (interquartile range: 1-6.5), with $48.7\%$ of events
                      occurring within 48 hours. Multivariate logistic regression
                      analysis demonstrates that continued intake of antiplatelet
                      drugs (OR 3.98, $95\%$ CI 0.89-10.12, p = 0.025) and flat
                      morphology of the colorectal lesion (OR 2.98, $95\%$ CI
                      1.08-8.01, p = 0.031) were associated with an increased risk
                      for late postprocedural bleeding (> 48 h), whereas
                      intraprocedural bleeding was associated with a decreased
                      risk (OR 0.12, $95\%$ CI 0.04-0.50, p = 0.001).
                      Discussion/Conclusion Significant postprocedural bleeding
                      can occur up to 18 days after endoscopic resection of
                      colorectal lesions, but was predominantly observed within 48
                      hours. Continued intake of antiplatelet drugs and a flat
                      morphology are associated with risk for late postprocedural
                      bleeding.},
      cin          = {C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37812925},
      doi          = {10.1159/000534109},
      url          = {https://inrepo02.dkfz.de/record/285407},
}