Aims:
Liver cirrhosis is an immunocompromised state. However, there have been no study about
infection rates and related risk factors in the patients with liver cirrhosis followed
by colonoscopic polypectomy including endoscopic mucosal resection (EMR) and endoscopic
submucosal dissection (ESD). We aimed to evaluate the incidence of infectious complication
followed by polypectomy and investigate risk factors of infectious complication in
these patients.
Methods:
In this multicenter, retrospective study involving 10 tertiary centers in Korea, we
evaluated 892 patients who had been diagnosed as liver cirrhosis and underwent colonoscopic
polypectomy from Jan 2013 to December 2017. We evaluate the incidence of infectious
complication after polypectomy and evaluated risk factors for infection.
Results:
Infection rate after colonoscopic polypectomy was 2.9% (26/486). The infection rates
of local infection, systemic infection and other infection were 2.1%, 1.2%, and 1.0%,
respectively. In univariate analysis, old age (odds ratio (OR)= 1.86, 95% confidence
interval (CI): 1.10 – 3.16, P = 0.002), hepatic dysfunction (OR = 4.50, CI: 1.96 –
10.50, P =< 0.001), the presence of ascites (OR = 2.00, CI: 1.00 – 4.54, P = 0.05),
and tumor size > 10 mm (OR = 2.72, CI: 1.23 – 6.02) are associated with infection.
In multivariate analysis, old age (OR = 1.79, 95% CI: 1.05 – 4.16, P = 0.010), hepatic
dysfunction (OR = 4.50, CI: 1.55 – 9.70, P = 0.005).
Conclusions:
Clinical infectious complication was relatively high in liver cirrhosis patient after
colonoscopic polypectomy, especially patient with old age or hepatic dysfunction,
which may warrant prophylactic administration of antibiotics in these high risk patients.
