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.
