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

• Published in: European journal of radiology 2020-12, Vol.133, p.109399-109399, Article 109399
• Main Authors: Lavian, J.D., Thornton, L.M., Zybulewski, A., Kim, E., Nowakowski, S.F., Ranade, M., Patel, R.S., Lookstein, R.A., Fischman, A., Bishay, V.
• Format: Article
• Language: English
• Subjects: Adult; Biopsy; Cardiac; Coagulopathy; Hematoma; Hepatic; Humans; Jugular Veins; level of evidence: level 3b; Liver; Middle Aged; Propensity Score; Retrospective case control study; Retrospective Studies; Transjugular
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2020.109399

•3 to 5 bullet points (maximum 85 characters, including spaces, per bullet point).•Cardiac complications more common with transjugular liver biopsy.•Bleeding complications more common with percutaneous liver biopsy.•Trend towards safety with transjugular compared to percutaneous given coagulopathy.•7-day readmission and mortality rates were comparable between biopsy groups. 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.