Immediate post-polypectomy bleeding is associated with an increased risk of delayed post-polypectomy bleeding: A large retrospective cohort study

doi:10.3748/wjg.118775

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jun 28, 2026; 32(24): 118775
Published online Jun 28, 2026. doi: 10.3748/wjg.118775

Table 1 Baseline characteristics of study population, mean ± SD/n (%)

Variables	IPPB only (n = 898)	DPPB after IPPB (n = 35)	P value
Patient-related factor
Demographic variables
Age, years	62.71 ± 11.27	63.63 ± 10.74	0.6359
Male	613 (68.26)	22 (62.86)	0.5010
Body mass index, kg/m²	23.81 ± 3.44	22.09 ± 3.34	0.0042^a
Comorbidities
Hypertension	238 (26.50)	10 (28.57)	0.7858
Diabetes mellitus	189 (21.05)	9 (25.71)	0.5076
Liver cirrhosis or chronic liver disease	30 (3.34)	0 (0.00)	0.6233
Cardiovascular and cerebrovascular disease	71 (7.91)	4 (11.43)	0.5184
Chronic kidney disease	148 (16.48)	9 (25.71)	0.1520
Cancers	194 (21.60)	9 (25.71)	0.5631
Medications
Antiplatelet agents	41 (4.57)	3 (8.57)	0.2254
Anticoagulants	17 (1.89)	1 (2.86)	0.5008
NSAIDs and corticosteroids	94 (10.47)	4 (11.43)	0.7795
Laboratory findings
Hemoglobin, g/dL	13.21 ± 2.07	12.92 ± 1.82	0.4219
Platelet count, 10⁹/L	234.15 ± 83.36	216.26 ± 72.70	0.2112
Prothrombin time, INR	1.01 ± 0.18	1.01 ± 0.17	0.8329
aPTT, second	31.55 ± 7.56	31.03 ± 5.62	0.6025
Polyp-related factors
Polyp number per patient	3.94 ± 3.43	5.60 ± 4.47	0.0367^a
Polyp size (mm)	9.09 ± 4.95	13.69 ± 8.00	0.0018^a
Polyp size (mm) > 10 mm	319 (35.64)	23 (65.71)	0.0003^a
Morphology (%)			0.4116
Non-pedunculated	496 (55.61)	17 (48.57)
Pedunculated	396 (44.39)	18 (51.43)
Location			0.4261
Right colon	467 (52.30)	22 (62.86)
Left colon	336 (37.63)	11 (31.43)
Rectum	90 (10.08)	2 (5.71)
Histopathologic results			0.0511
Adenomatous	455 (71.77)	24 (88.89)
Non-adenomatous	179 (28.23)	3 (11.11)
Procedure-related factors
Resection method			0.8104
Cold (CFP, CSP)	227 (25.42)	9 (27.27)
Hot (EMR, ESD)	666 (74.58)	24 (72.73)
Procedure time, minute	40.48 ± 20.57	47.67 ± 24.05	0.0442^a
Insertion time	10.23 ± 16.83	8.97 ± 6.53	0.3168
Withdrawal time	30.26 ± 22.60	38.70 ± 22.65	0.0305^a
Endoscopist experience			0.0712
Experienced	283 (31.51)	6 (17.14)
Trainee	615 (68.49)	29 (82.86)
Bowel preparation			0.4183
Excellent + good	749 (83.41)	31 (88.57)
Adequate + poor	149 (16.59)	4 (11.43)
Hemostasis or preventive hemostasis	531 (59.13)	21 (60.00)	0.9183

^aP < 0.05.

IPPB: Immediate post-polypectomy bleeding; DPPB: Delayed post-polypectomy bleeding; NSAIDs: Nonsteroidal anti-inflammatory drug; INR: International normalized ratio; aPTT: Activated partial thromboplastin time; CFP: Cold forceps polypectomy; CSP: Cold snare polypectomy; EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection.

Full Size Table

Table 2 Risk factors for delayed post-polypectomy bleeding among immediate post-polypectomy bleeding patients

Variable	Univariate OR (95%CI)	P value	Multivariable¹ OR (95%CI)	P value
Patient-related factor
Age (per year)	1.007 (0.977-1.039)	0.6355
Male sex	0.787 (0.391-1.584)	0.5018
BMI	0.847 (0.758-0.947)	0.0037	0.901 (0.797-1.018)	0.0930
Hypertension	1.109 (0.525-2.344)	0.7859
Diabetes mellitus	1.299 (0.598-2.818)	0.5084
Chronic kidney disease	1.754 (0.806-3.820)	0.1570	1.699 (0.707-4.082)	0.2362
Polyp-related factors
Polyp number	1.105 (1.027-1.187)	0.0071	1.041 (0.939-1.156)	0.4437
Polyp size (per mm)	1.105 (1.059-1.152)	< 0.0001	1.056 (0.989-1.129)	0.1050
Polyp size ≥ 10 mm	3.461 (1.700-7.048)	0.0006	Excluded²
Non-adenomatous polyp	0.318 (0.095-1.068)	0.0639	0.364 (0.106-1.243)	0.1067
Procedure-related factors
Procedure time (per minute)	1.013 (1.000-1.025)	0.0470	0.997 (0.978-1.017)	0.7651
Withdrawal time (minute)	1.016 (1.003-1.029)	0.0157	Excluded²
Trainee endoscopist	2.224 (0.913-5.417)	0.0784	3.091 (1.037-9.219)	0.0429

¹Multivariable model included variables with P < 0.2 in univariate analysis.

²Excluded from multivariable model: Polyp size ≥ 10 mm due to collinearity with continuous polyp size; Withdrawal time due to collinearity with total procedure time.

Bold P value indicates P < 0.2 in univariate analysis or P < 0.05 in multivariable analysis. OR: Odds ratio; CI: Confidence interval; BMI: Body mass index.

Full Size Table

Citation: Hwang JH, Hyun HK, Gwon SH, Son NH, Huh CW. Immediate post-polypectomy bleeding is associated with an increased risk of delayed post-polypectomy bleeding: A large retrospective cohort study. World J Gastroenterol 2026; 32(24): 118775
URL: https://www.wjgnet.com/1007-9327/full/v32/i24/118775.htm
DOI: https://dx.doi.org/10.3748/wjg.118775

Hwang JH, Hyun HK, Gwon SH, Son NH, Huh CW. Immediate post-polypectomy bleeding is associated with an increased risk of delayed post-polypectomy bleeding: A large retrospective cohort study. World J Gastroenterol 2026; 32(24): 118775 [DOI: 10.3748/wjg.118775]

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