Safety of percutaneous versus transjugular liver biopsy: A propensity score matched analysis.

Nov 19, 2020

Contributor: J D Lavian,L M Thornton,A Zybulewski,E Kim,S F Nowakowski,M Ranade,R S Patel,R A Lookstein,A Fischman,V Bishay

Safety of percutaneous versus transjugular liver biopsy: A propensity score matched analysis.

This study sought to identify the complication, mortality, and readmission rates of patients undergoing either percutaneous (PCLB) or transjugular liver biopsy (TJLB) when propensity matched for demographics and hepatic comorbidities.
A retrospective review of New York’s Statewide Planning and Research Cooperative System ICD9 coded database from the years 2009-2013 was conducted. Patients over the age of 18 undergoing either PCLB or TJLB were included. Patients with hepatic neoplasm or metastasis were excluded. 2:1 PCLB:TJLB propensity match for age, race, payment, coagulopathy, thrombocytopenia/purpura, hypercoagulability, ascites, acute liver failure, chronic hepatitis, cirrhosis, and bone marrow disease was conducted. Univariate analysis compared demographics, complications, readmissions, and mortality.
1467 patients met inclusion criteria (PCLB = 978, TJLB = 489). Propensity match was successful in that there were no significant differences in demographics or hepatic comorbidities. TJLB had significantly lower rates of hematoma (0.20 % vs 1.20 %, p = 0.049) and higher rates of cardiac complications (0.40 % vs 0.00 %, p = 0.045). Other complication, readmission, and mortality rates did not differ significantly. Logistic regression found no significant predictors of readmission within 7 days or any complication within 5 days.
This retrospective, multi-center database review of adult patients undergoing PCLB or TJLB propensity matched for demographics and hepatic comorbidities found that TJLB patients had a significantly higher rate of cardiac complications while PCLB patients had a significantly higher rate of hematoma. These findings support prior literature suggesting a trend towards safety of TJLB compared to PCLB in patients with hemostatic disorders and/or advanced liver disease.

Copyright © 2020 Elsevier B.V. All rights reserved.

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About The Expert

J D Lavian

Department of Diagnostic and Interventional Radiology, State University of New York ‑ Downstate Medical Center, Brooklyn, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: Joshua.lavian@downstate.edu.

L M Thornton

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: lmkarr1188@gmail.com.

A Zybulewski

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: arzybule@gmail.com.

E Kim

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: edward.kim@mountsinai.org.

S F Nowakowski

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: scott.nowakowski@mountsinai.org.

M Ranade

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: mona.ranade@mountsinai.org.

R S Patel

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: rahul.patel@mountsinai.org.

R A Lookstein

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: robert.lookstein@mssm.edu.

A Fischman

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: aaron.fischman@mountsinai.org.

V Bishay

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address: vivian.bishay@mountsinai.org.

References

PubMed