Article Dans Une Revue Endoscopy Année : 2023

Risk of delayed bleeding after colorectal endoscopic submucosal dissection: the Limoges Bleeding Score

Jérémie Albouys
Sheyla Montori Pina
Safia Boukechiche
  • Fonction : Auteur
Eduardo Albéniz
Hugo Lepetit
  • Fonction : Auteur
Mathieu Pioche
Sophie Geyl
  • Fonction : Auteur
Virginie Valgueblasse
  • Fonction : Auteur
Clémentine Brule
  • Fonction : Auteur
Rebecca Rodrigues
  • Fonction : Auteur
Monica Enguita German
  • Fonction : Auteur

Résumé

Abstract Background Clinically significant delayed bleeding (CSDB) is a frequent, and sometimes severe, adverse event after colorectal endoscopic submucosal dissection (ESD). We evaluated risk factors of CSDB after colorectal ESD. Methods We analyzed a prospective registry of 940 colorectal ESDs performed from 2013 to 2022. The incidence of bleeding was evaluated up to 30 days. Risk factors for delayed bleeding were evaluated by multivariate logistic regression. A Korean scoring model was tested, and a new risk-scoring model was developed and internally validated. Results CSDB occurred in 75 patients (8.0%). The Korean score performed poorly in our cohort, with a receiver operating characteristic (ROC) curve of 0.567. In the multivariate analysis, risk factors were age ≥75 years (odds ratio [OR] 1.63; 95%CI 0.97–2.73; 1 point), use of antithrombotics (OR 1.72; 95%CI 1.01–2.94; 1 point), rectal location (OR 1.51; 95%CI 0.92–2.48; 1 point), size >50 mm (OR 3.67; 95%CI 2.02–7.14; 3 points), and American Society of Anesthesiologists (ASA) score of III or IV (OR 2.26; 95%CI 1.32–3.92; 2 points). The model showed fair calibration and good discrimination, with an area under the ROC curve of 0.751 (95%CI 0.690–0.812). The score was used to define two groups of patients, those with low–medium risk (0 to 4 points) and high risk (5 to 8 points) for CSDB (respective bleeding rates 4.1% and 17.5%). Conclusion A score based on five simple and meaningful variables was predictive of CSDB.

Dates et versions

hal-04647779 , version 1 (15-07-2024)

Identifiants

Citer

Jérémie Albouys, Sheyla Montori Pina, Safia Boukechiche, Eduardo Albéniz, Guillaume Vidal, et al.. Risk of delayed bleeding after colorectal endoscopic submucosal dissection: the Limoges Bleeding Score. Endoscopy, 2023, 56 (02), pp.110-118. ⟨10.1055/a-2189-0807⟩. ⟨hal-04647779⟩
124 Consultations
0 Téléchargements

Altmetric

Partager

  • More