Assessing the Need for Preprocedural Laboratory Tests and Stopping Non-steroidal Anti-inflammatory Drugs/Aspirin in Patients Undergoing Percutaneous Bone and Soft Tissue Biopsies.

Abstract

Although image-guided biopsies of bone and soft tissue lesions have a low complication rate, there is limited data evaluating use of preprocedural laboratory tests. To address this issue, patients were not required to stop non-steroidal antiinflammatory drugs (NSAIDs) and aspirin or to obtain preprocedural laboratory tests [complete blood count (CBC) and international normalized ratio (INR)], except in special circumstances. The bleeding complication rate, rate of same day biopsies, and the time from when the biopsy was ordered to when it was performed were obtained. A total of 332 patients who underwent bone or soft tissue biopsies performed at our institution between 9/1/2017 and 1/9/2019 were prospectively analyzed. These data were compared to a retrospective biopsy cohort of 323 patients between 7/1/2015 and 7/1/2017. Data collected included method of image guidance and bleeding complication rate. The number of days from ordering to performing a biopsy and number of same day biopsies were recorded. There were no bleeding complications in either cohort (OR 1.00, P = 1). The mean time from ordering to performing a bone biopsy was significantly decreased in the prospective group (6.6days) compared to the retrospective group (8.1days) (P = 0.012). There were more same day biopsies in the prospective cohort (11.4% vs. 3.4%) (P < 0.001). Preprocedural CBC and INR for bone and soft tissue biopsies can be safely eliminated in most patients. Biopsies performed while patients are taking NSAIDs/aspirin can safely be performed. Adopting revised preprocedural laboratory criteria can result in decreased time to completion of biopsies.