Bridge Therapy with Heparin Is the Largest Risk Factor for Postpolypectomy Bleeding

Risk factors for delayed postpolypectomy hemorrhage include increasing polyp size, proximal colon location, and use of anticoagulation or clopidogrel.

In a retrospective study conducted at two U.S. Veterans Administration hospitals, the overall risk for postpolypectomy bleeding among over 20,000 patients undergoing polypectomy was 0.4%. The risk in patients on warfarin was 0.7%, on clopidogrel, 0.8%, and on aspirin, 0.9%. Postprocedure bridge therapy with low-molecular-weight heparin was associated with a 15% risk for postpolypectomy bleeding.

In a case-control study, risk factors for bleeding included large polyp size (≥2 cm), multiple large polyps, a right-colon polyp removed with electrocautery, and restarting antithrombotics within a week…