Serum C-reactive protein as a possible marker to predict delayed hemorrhage after colonoscopic polypectomy
Liangqin Wu, Tiemei Han, Xiaoyuan Fan, Wensheng Pan, Chunfu Wang, Hua Zhong, Xinbo Ai, Wanjun Zhang, Xiang Xu, Zaiyuan Ye, Takesh Terai, Nobuhiro Sato, Sumio Watanabe, Undurti N. Das
Med Sci Monit 2012; 18(8): CR480-485
Background: Post-polypectomy hemorrhage is one of the complications of colonscopic polypectomy. And there is no definitive and convenient laboratory test that could be used to predict risk of delayed post-polypectomy hemorrhage. This research aimed to study risk prediction of delayed post-polypectomy hemorrhage using serum C-reactive protein (CRP) level as a marker.
Material/Methods: In a retrospective, case-controlled study, 302 cases of post-polypectomy patients were divided into hemorrhage group and non-hemorrhage group. The CRP levels 24-hours after colonscopic treatment were compared between the two groups to assess whether elevated serum CRP levels in addition to other risk factors such as age, gender, smoking, alcohol consumption, hypertension (AHT) and size of polyps may predict risk of delayed post-polypectomy hemorrhage.
Results: The hemorrhage group had significantly higher levels of serum CRP (32.50±17.34 mg/L vs. 6. 32±6.02 mg/dL) and were also having a higher incidence of hypertension compared to the non- hemorrhage group (both P<0.05). Patients with elevated serum CRP levels (≥10mg/L) after colonscopic treatment are at a higher risk of developing post-polypectomy hemorrhage (OR 1.329, 95%CI 1.125–1.571) as compared with patients whose CRP levels were not increased.
Conclusions: A higher level of serum CRP may serve as an indicator of delayed post-polypectomy hemorrhage and there appears to be a direct relationship between the serum CRP levels and the risk of post-polypectomy hemorrhage: the higher CRP levels the higher the risk of post-polypectomy hemorrhage.
Keywords: Multivariate Analysis, Male, Middle Aged, Logistic Models, Intestinal Polyps - surgery, Humans, Hemorrhage - etiology, Female, Colonoscopy - adverse effects, C-Reactive Protein - metabolism, Biological Markers, Postoperative Complications - etiology, Risk Factors