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Introduction <p>Esophagogastroduodenoscopy (EGD) with endoscopic mucosal resection (EMR) is commonly used for evaluating and managing gastrointestinal lesions. This study aimed to assess the 30-day risk of bleeding and other adverse outcomes following EGD-EMR in cirrhotic patients.</p> Methods <p>This retrospective cohort study utilized data from the US Collaborative Network to evaluate bleeding risk following EGD-EMR in cirrhotic patients. One-to-one propensity score matching was performed, with the primary outcome being bleeding within 30 days post-procedure.</p> Results <p>Each cohort included 1,045 patients. Cirrhotic patients had higher risk of post-EGD-EMR bleeding (OR 1.65, 95% CI 1.21–2.25, P = 0.002) and were more likely to require a blood transfusion (OR 2.54, 95% CI 1.21–5.31, P = 0.011). However, ICU admissions (OR 1.33, P = 0.29) and endoscopic reinterventions (OR 1.31, P = 0.25) did not differ significantly. Patients with decompensated cirrhosis had a higher bleeding risk compared to controls (OR 1.62, 95% CI 1.05–2.51, P = 0.03), while those with compensated cirrhosis showed no increased risk (OR 1.16, P = 0.55).</p> Discussion <p>This study found increased post-procedural bleeding in cirrhotic patients, particularly those with decompensated cirrhosis. Careful pre-procedural management of coagulopathy is crucial to minimize complications in these patients.</p>

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Risk of bleeding after esophagogastroduodenoscopy with mucosal resection in patients with cirrhosis

  • 期刊论文

  • 发表日期：

    2025年11月26日

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  • Razan Aburumman,
  • Saqr Alsakarneh,
  • Sumit Singla

摘要

Introduction

Esophagogastroduodenoscopy (EGD) with endoscopic mucosal resection (EMR) is commonly used for evaluating and managing gastrointestinal lesions. This study aimed to assess the 30-day risk of bleeding and other adverse outcomes following EGD-EMR in cirrhotic patients.

Methods

This retrospective cohort study utilized data from the US Collaborative Network to evaluate bleeding risk following EGD-EMR in cirrhotic patients. One-to-one propensity score matching was performed, with the primary outcome being bleeding within 30 days post-procedure.

Results

Each cohort included 1,045 patients. Cirrhotic patients had higher risk of post-EGD-EMR bleeding (OR 1.65, 95% CI 1.21–2.25, P = 0.002) and were more likely to require a blood transfusion (OR 2.54, 95% CI 1.21–5.31, P = 0.011). However, ICU admissions (OR 1.33, P = 0.29) and endoscopic reinterventions (OR 1.31, P = 0.25) did not differ significantly. Patients with decompensated cirrhosis had a higher bleeding risk compared to controls (OR 1.62, 95% CI 1.05–2.51, P = 0.03), while those with compensated cirrhosis showed no increased risk (OR 1.16, P = 0.55).

Discussion

This study found increased post-procedural bleeding in cirrhotic patients, particularly those with decompensated cirrhosis. Careful pre-procedural management of coagulopathy is crucial to minimize complications in these patients.