Clin Endosc.  2014 May;47(3):236-241. 10.5946/ce.2014.47.3.236.

Postpolypectomy Fever, a Rare Adverse Event of Polypectomy: Nested Case-Control Study

Affiliations
  • 1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. capsulendos@gmail.com

Abstract

BACKGROUND/AIMS
Although postpolypectomy fever (PPF) without colon perforation or hemorrhage is rare, its incidence and risk factors have not been investigated. The objective of this study was to analyze the incidence and risk factors for PPF among inpatients.
METHODS
Seven patients with PPF were matched with 70 patients without PPF from a total of 3,444 patients who underwent colonoscopic polypectomy. The PPF incidence during index hospitalization after colonoscopy was calculated, and univariate and multivariate analyses were performed to calculate the adjusted odds ratios (ORs) for risk factors.
RESULTS
PPF without bleeding or perforation in the colon occurred in seven patients (0.2%). The median age was 58 years for cases and 61 years for controls. The median interval from polypectomy to occurrence of fever was 7 hours, and the median duration of fever was 9 hours. Polyp size >2 cm (adjusted OR, 1.08; 95% confidence interval [CI], 1.01 to 1.15; p=0.02) and hypertension (adjusted OR, 14.40; 95% CI, 1.23 to 180.87; p=0.03) were associated with a significantly increased risk of PPF. PPF increased the length of hospitalization.
CONCLUSIONS
Although the crude incidence of PPF is low, PPF may prolong hospitalization. Risk factors for PPF include hypertension and large polyps.

Keyword

Postpolypectomy syndrome; Colonoscopic polypectomy

MeSH Terms

Case-Control Studies*
Colon
Colonoscopy
Fever*
Hemorrhage
Hospitalization
Humans
Hypertension
Incidence
Inpatients
Multivariate Analysis
Odds Ratio
Polyps
Risk Factors

Cited by  1 articles

What Is Different between Postpolypectomy Fever and Postpolypectomy Coagulation Syndrome?
Hyung Wook Kim
Clin Endosc. 2014;47(3):205-206.    doi: 10.5946/ce.2014.47.3.205.


Reference

1. Winawer SJ, Zauber AG, Ho MN, et al. The National Polyp Study Workgroup. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993; 329:1977–1981. PMID: 8247072.
Article
2. ASGE Standards of Practice Committee. Fisher DA, Maple JT, et al. Complications of colonoscopy. Gastrointest Endosc. 2011; 74:745–752. PMID: 21951473.
Article
3. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007; 116:1736–1754. PMID: 17446442.
4. Waye JD, Lewis BS, Yessayan S. Colonoscopy: a prospective report of complications. J Clin Gastroenterol. 1992; 15:347–351. PMID: 1294644.
5. Waye JD, Kahn O, Auerbach ME. Complications of colonoscopy and flexible sigmoidoscopy. Gastrointest Endosc Clin N Am. 1996; 6:343–377. PMID: 8673332.
Article
6. Cha JM, Lim KS, Lee SH, et al. Clinical outcomes and risk factors of post-polypectomy coagulation syndrome: a multicenter, retrospective, case-control study. Endoscopy. 2013; 45:202–207. PMID: 23381948.
Article
7. Chilton AP, O'Sullivan M, Cox MA, Loft DE, Nwokolo CU. A blinded, randomized comparison of a novel, low-dose, triple regimen with fleet phospho-soda: a study of colon cleanliness, speed and success of colonoscopy. Endoscopy. 2000; 32:37–41. PMID: 10691270.
8. Gurudu SR, Ratuapli S, Heigh R, DiBaise J, Leighton J, Crowell M. Quality of bowel cleansing for afternoon colonoscopy is influenced by time of administration. Am J Gastroenterol. 2010; 105:2318–2322. PMID: 21048676.
Article
9. Botoman VA, Surawicz CM. Bacteremia with gastrointestinal endoscopic procedures. Gastrointest Endosc. 1986; 32:342–346. PMID: 3533703.
Article
10. Welsch T, Müller SA, Ulrich A, et al. C-reactive protein as early predictor for infectious postoperative complications in rectal surgery. Int J Colorectal Dis. 2007; 22:1499–1507. PMID: 17639424.
Article
11. Fatima H, Rex DK. Minimizing endoscopic complications: colonoscopic polypectomy. Gastrointest Endosc Clin N Am. 2007; 17:145–156. PMID: 17397781.
Article
12. Levy MJ, Norton ID, Clain JE, et al. Prospective study of bacteremia and complications with EUS FNA of rectal and perirectal lesions. Clin Gastroenterol Hepatol. 2007; 5:684–689. PMID: 17544995.
Article
13. Janssen J, König K, Knop-Hammad V, Johanns W, Greiner L. Frequency of bacteremia after linear EUS of the upper GI tract with and without FNA. Gastrointest Endosc. 2004; 59:339–344. PMID: 14997128.
Article
14. Min BH, Chang DK, Kim DU, et al. Low frequency of bacteremia after an endoscopic resection for large colorectal tumors in spite of extensive submucosal exposure. Gastrointest Endosc. 2008; 68:105–110. PMID: 18402955.
Article
15. McLean MH, Murray GI, Stewart KN, et al. The inflammatory microenvironment in colorectal neoplasia. PLoS One. 2011; 6:e15366. PMID: 21249124.
Article
16. Schiffrin EL. The immune system: role in hypertension. Can J Cardiol. 2013; 29:543–548. PMID: 22902155.
Article
17. Granger JP. An emerging role for inflammatory cytokines in hypertension. Am J Physiol Heart Circ Physiol. 2006; 290:H923–H924. PMID: 16467462.
Article
Full Text Links
  • CE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr