Page 75 - 北京京煤集团总医院第十一届·2023学术年会论文集

北京京煤集团总医院 第十一届·2023 学术年会论文集

3.4.7. Sensitivity analysis
2
In this study, when the amount of heterogeneity for a factor was high (I >50%), sensitivity analyses
were performed (Fig. S44-62). Regarding aspirin, sensitivity analysis (Fig. S44) revealed that
excluding the study by Xianyi Lin led to results that were outside of the 95% CI as well as a lower
2
level of heterogeneity (I = 0.0%, p=0.159) (Fig. S35b). Therefore, this study may be a significant
source of heterogeneity in the multivariate analysis of aspirin. Regarding pedunculated polyp and

polyp size, sensitivity analysis revealed that the results remained within the 95% CI (Fig. S45-46),
and thus, the findings were stable. Sensitivity analysis also revealed that the effects of smoking,
diabetes, antithrombotic drugs, polyp located in left semicolon, right semicolon, adenoma,
proliferative polyps, EMR, HSP, experienced and inexperienced endoscopists (Fig. S47-57) on the

incidence of DPPB were stable. Due to the small number of included studies (2 articles), sensitivity
analysis could not be performed to examine warfarin, polyp number ≥ 3, non-adenoma, ESD, and
APC (Fig. S58-62).
4. Discussion

As one of the complications that can occur after endoscopic resection of colorectal polyps, DPPB
may cause hemorrhagic shock and increase the risk of mortality if it is not treated in a timely
manner [24] . Moreover, most DPPB patients need to undergo colonoscopy again, thereby increasing

patients' pain and economic losses as well as affecting the harmony of the doctor‒patient
relationship. Therefore, DPPB is an important problem for endoscopists, but its etiology and
mechanism remain unclear. Domestic and foreign studies have reported that the occurrence of DPPB
is related to a variety of factors. The current meta-analysis included both univariate logistic

regression and multivariate logistic regression, and the results revealed that male sex, history of
hypertension, history of anticoagulant drug use, history of aspirin use, polyp size ≥10 mm, and
polyps with treads were risk factors for DPPB. The results of multivariate logistic regression meta-
analysis showed a significant correlation, while the results of Univariate logistic regression revealed

a history of diabetes, polyp number≥3, polyp size > 10 mm, and polyps located in the right half
colon were not associated with the risk of DPPB, which might be attributed to the correlation
between these 5 factors and confounding factors.
Regarding patient-related factors, this study found that male patients were more likely to develop

DPPB. The reason for this association may be related to the poor compliance with postpolypectomy
medical advice that is observed among male patients. Although male patients would give assurances
that they were following their doctor's instructions correctly, this was questionable. Previous studies

of medical compliance have shown gender differences. They found significantly higher levels of
disobedience among men, which could be attributed to emotional factors. On the other hand, women
are more likely to follow behavioral instructions [25] . Vascular endothelial cell dysfunction in patients
with hypertension can seriously affect the systolic blood pressure, the diastolic function of blood
vessels, and vascular sclerosis; furthermore, this dysfunction can lead to decreased blood elasticity

and significantly decreased contractility of blood vessels at the broken end [26] . In addition, the effects

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