Evidence map›Paper›PMID 35028791›Full record

ArticleDigestive diseases and sciences2022

Timing of Resumption of Anticoagulation After Polypectomy and Frequency of Post-procedural Complications: A Post-hoc Analysis.

Benjamin R Chebaa, Brandon Burgman, Andrew D Smith, Daniel S Kim, Tisha Lunsford, Miriam Mara, Leon Kundrotas, Kerry B Dunbar, Stuart J Spechler, S Stephen Yi and 1 more

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Article in Digestive diseases and sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Benjamin R Chebaa *Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Health Discovery Building, 1601 Trinity Street, Building B, Austin, TX, 78712, USA.
Brandon Burgman *Department of Oncology, Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Andrew D SmithDepartment of Medicine, VA North Texas Healthcare System, Dallas, TX, USA.
Daniel S KimDepartment of Medicine, VA North Texas Healthcare System, Dallas, TX, USA.
Tisha LunsfordDivision of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA.
Miriam MaraDepartment of Medicine, South Texas Veterans Healthcare System, San Antonio, TX, USA.
Leon KundrotasDepartment of Medicine, South Texas Veterans Healthcare System, San Antonio, TX, USA.
Kerry B DunbarDepartment of Medicine, VA North Texas Healthcare System, Dallas, TX, USA.
Stuart J SpechlerDepartment of Medicine and Center for Esophageal Diseases, Baylor University Medical Center, Dallas, TX, USA.
S Stephen YiDepartment of Oncology, Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Linda A FeaginsDepartment of Internal Medicine, Dell Medical School, The University of Texas at Austin, Health Discovery Building, 1601 Trinity Street, Building B, Austin, TX, 78712, USA. linda.feagins@austin.utexas.edu.ORCID 0000-0001-7758-3257

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOptimal timing for anticoagulation resumption after polypectomy is unclear. We explored the association between timing of anticoagulation resumption and occurrence of delayed post-polypectomy bleeding (PPB) and thromboembolic (TE) events.

methodsWe performed a post-hoc analysis of patients in an earlier study whose anticoagulants were interrupted for polypectomy. We compared rates of clinically important delayed PPB and TE events in relationship to timing of anticoagulant resumption. Late resumption was defined as > 2 days after polypectomy.

resultsAmong 437 patients, 351 had early and 86 late resumption. Compared to early resumers, late resumers had greater polypectomy complexity. PPB rate was higher (but not significantly) in the late versus early resumers (2.3% vs. 0.9%, 1.47% greater, 95% CI [- 2.58 to 5.52], p = 0.26). TE events were more frequent in late versus early resumers [0% vs. 1.2% at 30 days, 0% vs. 2.3%, 95% CI 0.3-8, (p = 0.04) at 90 days]. On multivariate analysis, timing of restarting anticoagulation was not a significant predictor of PPB (OR 0.97, 95% CI 0.61-1.44, p = 0.897). Significant predictors were number of polyps ≥ 1 cm (OR 4.14, 95% CI 1.27-13.66, p = 0.014) and use of fulguration (OR 11.43, 95% CI 1.35-80.80, p = 0.014).

conclusionsPhysicians delayed anticoagulation resumption more commonly after complex polypectomies. The timing of restarting anticoagulation was not a significant risk factor for PPB and late resumers had significantly higher rates of TE events within 90 days. Considering the potentially catastrophic consequences of TE events and the generally benign outcome of PPBs, clinicians should be cautious about delaying resumption of anticoagulation after polypectomy.

Indexed as

Colonic PolypsThromboembolismAnticoagulantsColonoscopyHemorrhageHumansRetrospective StudiesAnticoagulantsAnticoagulationColonoscopyGastrointestinal bleedingPolypectomyThromboembolism

Identifiers

PMID35028791

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