Postpolypectomy Fever, a Rare Adverse Event of Polypectomy:Nested Case-Control Study
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Background/Aims: Although postpolypectomy fever (PPF) without colon perforation or hemorrhage is rare, its incidence and risk factorshave not been investigated. The objective of this study was to analyze the incidence and risk factors for PPF among inpatients. Methods: Seven patients with PPF were matched with 70 patients without PPF from a total of 3,444 patients who underwent colonoscopicpolypectomy. The PPF incidence during index hospitalization after colonoscopy was calculated, and univariate and multivariateanalyses were performed to calculate the adjusted odds ratios (ORs) for risk factors. Results: PPF without bleeding or perforation in the colon occurred in seven patients (0.2%). The median age was 58 years for cases and61 years for controls. The median interval from polypectomy to occurrence of fever was 7 hours, and the median duration of fever was 9hours. Polyp size >2 cm (adjusted OR, 1.08; 95% confidence interval [CI], 1.01 to 1.15; p=0.02) and hypertension (adjusted OR, 14.40;95% CI, 1.23 to 180.87; p=0.03) were associated with a significantly increased risk of PPF. PPF increased the length of hospitalization. Conclusions: Although the crude incidence of PPF is low, PPF may prolong hospitalization. Risk factors for PPF include hypertensionand large polyps.
Abstract
Background/Aims: Although postpolypectomy fever (PPF) without colon perforation or hemorrhage is rare, its incidence and risk factorshave not been investigated. The objective of this study was to analyze the incidence and risk factors for PPF among inpatients. Methods: Seven patients with PPF were matched with 70 patients without PPF from a total of 3,444 patients who underwent colonoscopicpolypectomy. The PPF incidence during index hospitalization after colonoscopy was calculated, and univariate and multivariateanalyses were performed to calculate the adjusted odds ratios (ORs) for risk factors. Results: PPF without bleeding or perforation in the colon occurred in seven patients (0.2%). The median age was 58 years for cases and61 years for controls. The median interval from polypectomy to occurrence of fever was 7 hours, and the median duration of fever was 9hours. Polyp size >2 cm (adjusted OR, 1.08; 95% confidence interval [CI], 1.01 to 1.15; p=0.02) and hypertension (adjusted OR, 14.40;95% CI, 1.23 to 180.87; p=0.03) were associated with a significantly increased risk of PPF. PPF increased the length of hospitalization. Conclusions: Although the crude incidence of PPF is low, PPF may prolong hospitalization. Risk factors for PPF include hypertensionand large polyps.
참고문헌 (17)
- Winawer SJ, "Prevention of colorectal cancer by colonoscopic polypectomy", N Engl J Med, 329, pp.1977~1981 (1993), The National Polyp Study Workgroup
- ASGE Standards of Practice Committee, "Complications of colonoscopy", Gastrointest Endosc, 74, pp.745~752 (2011)
- Wilson W, "Prevention of infective endocarditis:guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group", Circulation, 116, pp.1736~1754 (2007)
- Waye JD, "Colonoscopy: a prospective report of complications", J Clin Gastroenterol, 15, pp.347~351 (1992)
- Waye JD, "Complications of colonoscopy and flexible sigmoidoscopy", Gastrointest Endosc Clin N Am, 6, pp.343~377 (1996)
- Cha JM, "Clinical outcomes and risk factors of post-polypectomy coagulation syndrome: a multicenter, retrospective, case-control study", Endoscopy, 45, pp.202~207 (2013)
- Chilton AP, "A blinded, randomized comparison of a novel, low-dose, triple regimen with fleet phospho-soda: a study of colon cleanliness, speed and success of colonoscopy", Endoscopy, 32, pp.37~41 (2000)
- Gurudu SR, "Quality of bowel cleansing for afternoon colonoscopy is influenced by time of administration", Am J Gastroenterol, 105, pp.2318~2322 (2010)
- Botoman VA, "Bacteremia with gastrointestinal endoscopic procedures", Gastrointest Endosc, 32, pp.342~346 (1986)
- Welsch T, "C-reactive protein as early predictor for infectious postoperative complications in rectal surgery", Int J Colorectal Dis, 22, pp.1499~1507 (2007)
- Fatima H, "Minimizing endoscopic complications: colonoscopic polypectomy", Gastrointest Endosc Clin N Am, 17, pp.145~156 (2007)
- Levy MJ, "Prospective study of bacteremia and complications with EUS FNA of rectal and perirectal lesions", Clin Gastroenterol Hepatol, 5, pp.684~689 (2007)
- Janssen J, "Frequency of bacteremia after linear EUS of the upper GI tract with and without FNA", Gastrointest Endosc, 59, pp.339~344 (2004)
- Min BH, "Low frequency of bacteremia after an endoscopic resection for large colorectal tumors in spite of extensive submucosal exposure", Gastrointest Endosc, 68, pp.105~110 (2008)
- McLean MH, "The inflammatory microenvironment in colorectal neoplasia", PLoS One, 6, pp.e15366~ (2011)
- Schiffrin EL, "The immune system: role in hypertension", Can J Cardiol, 29, pp.543~548 (2013)
- Granger JP, "An emerging role for inflammatory cytokines in hypertension", Am J Physiol Heart Circ Physiol, 290, pp.H923~H924 (2006)