3:45 PM Abstract No. 204 Safety of percutaneous versus transjugular liver biopsy: a propensity score matched analysis

Abstract

This study sought to identify the complication 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 State’s ICD9 coded Statewide Planning and Research Cooperative System database years 2009 – 2013 was conducted. Patients over the age of 18 undergoing either PCLB or TJLB were included. Patients undergoing any other simultaneous vascular procedure, liver procedure, or 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. Binary logistic and linear regression identified independen 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 higher rates of cardiac complications (0.40% vs. 0.00%, P = 0.045). PCLB patients had significantly higher rates of hematoma (1.20% vs. 0.20%, P = 0.049). 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, multicenter 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.