In this study, researchers from Germany retrospectively assessed the risk of bleeding after percutaneous liver biopsy.
They analyzed 629 procedures, paying particular attention to patients with an increased a priori bleeding risk.
|58% of the bleeding events occurred in patients with particular risk factors for bleeding.|
Any factors which may have been related to the risk of bleeding were analyzed by univariate analysis.
The team used a forward conditional logistic regression to further analyze any variables which were significant in the univariate analysis.
The team identified biopsy-related bleeding events in 2% of patients, an unexplained drop in serum hemoglobin concentration of more than 2 g/dl in 7%, and an intra- or extra-hepatic hematoma assessed by ultrasound in 3%.
The researchers found that 58% of the bleeding events occurred in patients with particular risk factors for bleeding.
They determined that biopsy-related mortality in this cohort was 0.48%.
They identified several independent risk factors for bleeding using logistic regression analysis. These included mycobacterial infection (OR 24.0), pre-biopsy prophylactic platelet substitution (OR 9.9), acute liver failure (OR 9.1), heparin administration on the day of biopsy (OR 8.7), advanced liver cirrhosis (OR 5.1), therapy with corticosteroids (OR 3.5) or metamizole (OR 2.8), and leukemia or lymphoma (OR 2.8).
Furthermore, the team found that delayed bleeding (more than 24 hours after biopsy) occurred in 70% of the bleeding events.
Dr Birgit Terjunga's team concluded, "In our study cohort which comprised a high proportion of patients with particular risk factors for bleeding, biopsy-related bleeding occurred more frequently and later than commonly observed.
It "was associated with only a few prognostic factors".
"Considering these predictors before liver biopsy will aid to reduce the rate of bleeding complications".