Bleeding After Endoscopic Procedures in Patients With Chronic Hematologic Thrombocytopenia.
Dig Dis Sci
; 62(3): 746-754, 2017 03.
Article
em En
| MEDLINE
| ID: mdl-28035550
ABSTRACT
BACKGROUND:
Procedure-induced bleeding is a major complication after endoscopic intervention.AIMS:
The aim of this study was to investigate the risk of endoscopy-related bleeding in patients with chronic hematologic thrombocytopenia.METHODS:
We investigated endoscopy-related bleeding in 175 procedures performed on 108 patients with immune thrombocytopenic purpura or aplastic anemia. The outcomes were compared with those of 350 procedures on age-, sex-, and procedure-matched control subjects. Endoscopic interventions included low-risk procedures such as endoscopic biopsy and high-risk procedures including polypectomy, endoscopic resection, and endoscopic retrograde cholangiopancreatogram with sphincterotomy.RESULTS:
Bleeding occurred in 17 (9.7%) procedures among the patients with thrombocytopenia. This rate was significantly higher than that in procedures on controls (3.1%, P = 0.003). About 60% of all bleeding events were observed within 24 h after the endoscopic procedure. Bleeding after endoscopic biopsy developed more frequently in the patient group than in the control group (7.1 vs. 0.7%; P < 0.001). Bleeding occurred after 20% of all high-risk procedures. The incidence of bleeding was significantly elevated in patients with a platelet count less than 50 × 103/µl. Multivariate analysis revealed that high-risk procedures and low platelet count (less than 50 × 103/µl) were significantly related to procedure-related bleeding. All bleeding events stopped spontaneously or were controlled with endoscopic hemostasis.CONCLUSIONS:
Endoscopic procedure-related bleeding develops frequently in patients with chronic hematologic thrombocytopenia. Post-procedural bleeding should be observed carefully in these patients, especially when the platelet count is less than 50 × 103/µl or high-risk endoscopic procedures are planned.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
3_ND
Base de dados:
MEDLINE
Assunto principal:
Púrpura Trombocitopênica
/
Trombocitopenia
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Endoscopia Gastrointestinal
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Hemorragia Pós-Operatória
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Hemorragia Gastrointestinal
/
Anemia Aplástica
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
Dig Dis Sci
Ano de publicação:
2017
Tipo de documento:
Article