Platelet and INR Thresholds and Bleeding Risk in Ultrasound Guided Percutaneous Liver Biopsy: A Before-After Implementation of the 2019 Society of Interventional Radiology Guidelines Observational Quality Improvement Study.

Autor:	DesRoche C; School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada., Callum J; Department of Pathology and Molecular Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada., Scholey A; Department of Pathology and Molecular Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada., Hajjaj OI; School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada., Flemming J; Department of Medicine and Public Health Sciences, Queen's University, Kingston, ON, Canada., Mussari B; Department of Diagnostic Radiology, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada., Tarulli E; Department of Diagnostic Radiology, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada., Reza Nasirzadeh A; Department of Diagnostic Radiology, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada., Menard A; Department of Diagnostic Radiology, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada.
Jazyk:	angličtina
Zdroj:	Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes [Can Assoc Radiol J] 2024 Nov; Vol. 75 (4), pp. 931-938. Date of Electronic Publication: 2024 May 16.
DOI:	10.1177/08465371241252059
Abstrakt:	Purpose: To evaluate if implementation of the 2019 Society of Interventional Radiology (SIR) guidelines for periprocedural management of bleeding risk in patients undergoing percutaneous ultrasound guided liver biopsy is associated with increased haemorrhagic adverse events, change in pre-procedural blood product utilization, and evaluation of guideline compliance rate at a single academic institution. Methods: Ultrasound guided percutaneous liver biopsies from (January 2019-January 2023) were retrospectively reviewed (n = 504), comparing biopsies performed using the 2012 SIR pre-procedural coagulation guidelines (n = 266) to those after implementation of the 2019 SIR pre-procedural guidelines (n = 238). Demographic, preprocedural transfusion, laboratory, and clinical data were reviewed. Chart review was conducted to evaluate the incidence of major bleeding adverse events defined as those resulting in transfusion, embolization, surgery, or death. Results: Implementation of the 2019 SIR periprocedural guidelines resulted in reduced guideline non-compliance related to the administration of blood products, from 5.3% to 1.7% ( P = .01). The rate of pre-procedural transfusion remained the same pre and post guidelines at 0.8%. There was no statistically significant change in the incidence of bleeding adverse events, 0.8% pre guidelines versus 0.4% post ( P = 1.0). Conclusion: Implementation of the 2019 SIR guidelines for periprocedural management of bleeding risk in patients undergoing percutaneous ultrasound guided liver biopsy did not result in an increase in bleeding adverse events or pre-procedural transfusion rates. The guidelines can be safely implemented in clinical practice with no increase in major adverse events. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Author Alexandre Menard receives a speaker honorarium from Inari Medical and Philips Imaging and has received payment for expert testimony from the College of Physicians and Surgeons on Ontario. Author Jeannie Callum has received research grants from Canadian Blood Services and Octapharma and participates on a Drug Safety Monitoring Board for the FEISTY Trauma Trial. Author Emidio Tarulli receives consulting fees from the Medfall Group. The authors declare that they have no conflict of interest not listed above.
Databáze:	MEDLINE
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