Risk Factors for Adverse Events in Image-guided Biopsies

Image-guided liver biopsies are generally safe procedures, but certain risk factors have been identified.

Image-guided liver biopsies can be performed safely, although adverse events can occur among patients with low platelet counts, according to a study published in Mayo Clinic Proceedings.

Researchers from the Mayo Clinic in Rochester, MN, performed a retrospective study to determine the incidence of major adverse events related to a large volume of image-guided liver biopsies performed at their institution over a 12-year period, and to identify risk factors for major bleeding events.

The researchers analyzed 6,613 image-guided liver biopsies that were performed among 5,987 adult patients between December 7, 2001, and December 31, 2013. They were searching for major adverse events, defined as hematoma, infection, pneumothorax, and death.

The biopsies were mostly performed using real-time US guidance.

The results showed that 49 biopsies (0.7%) resulted in acute or major adverse events.

Adverse EventNumber of Patients
Hematoma requiring transfusion and/or angiographic intervention34 (0.5%)
Infection8 (0.1%)
Hemothorax4 (0.06%)
Pneumothorax0 (0%)
Death within 30 days of biopsy (death was directly related to biopsy)3 (0.05%)

A total of 38 patients experienced 46 major adverse events that presented within 24 hours of the biopsy. “More than two biopsy passes, platelets 50,000/μL or less, and female sex were statistically significant risk factors for postbiopsy hemorrhage,” the authors wrote.

“With appreciation of specific risk factors, safety outcomes of this procedure can be optimized in both general and specialized centers,” the authors concluded.