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息肉切除术后发热,一种息肉切除术罕见的不良事件:巢式病例对照研究

Postpolypectomy Fever, a rare adverse event of polypectomy: nested case-control study.

作者信息

Lee Seung-Hoon, Kim Kyung-Jo, Yang Dong-Hoon, Jeong Kee Wook, Ye Byong Duk, Byeon Jeong-Sik, Myung Seung-Jae, Yang Suk-Kyun, Kim Jin-Ho

机构信息

Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Clin Endosc. 2014 May;47(3):236-41. doi: 10.5946/ce.2014.47.3.236. Epub 2014 May 31.

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.

摘要

背景/目的:尽管无结肠穿孔或出血的息肉切除术后发热(PPF)较为罕见,但其发病率及危险因素尚未得到研究。本研究的目的是分析住院患者中PPF的发病率及危险因素。

方法

从3444例行结肠镜息肉切除术的患者中,选取7例PPF患者与70例无PPF患者进行匹配。计算结肠镜检查后首次住院期间的PPF发病率,并进行单因素和多因素分析以计算危险因素的调整比值比(OR)。

结果

7例患者(0.2%)出现无结肠出血或穿孔的PPF。病例组的中位年龄为58岁,对照组为61岁。从息肉切除到发热出现的中位间隔时间为7小时,发热的中位持续时间为9小时。息肉大小>2 cm(调整OR,1.08;95%置信区间[CI],1.01至1.15;p=0.02)和高血压(调整OR,14.40;95%CI,1.23至180.87;p=0.03)与PPF风险显著增加相关。PPF延长了住院时间。

结论

尽管PPF的粗发病率较低,但PPF可能会延长住院时间。PPF的危险因素包括高血压和大息肉。

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