Safety of omitting routine bleeding tests prior to image-guided musculoskeletal core needle biopsy
| Autor: | Yuri Shif, Colm J. McMahon, Megan E. Anderson, Jim S. Wu, Jennifer Ni Mhuircheartaigh, Yu-Ching Lin, Justin W. Kung |
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| Rok vydání: | 2017 |
| Předmět: |
Image-Guided Biopsy
Male Core needle medicine.medical_specialty Ecchymosis Bone Neoplasms Hemorrhage Soft Tissue Neoplasms Radiography Interventional 030218 nuclear medicine & medical imaging 03 medical and health sciences Liver disease 0302 clinical medicine Risk Factors Biopsy medicine Coagulation testing Humans Radiology Nuclear Medicine and imaging Platelet International Normalized Ratio Ultrasonography Interventional Retrospective Studies Hematoma Retrospective review medicine.diagnostic_test Platelet Count business.industry medicine.disease Surgery body regions Bleeding complication 030220 oncology & carcinogenesis Orthopedic surgery Female Biopsy Large-Core Needle Radiology Tomography X-Ray Computed business |
| Zdroj: | Skeletal Radiology. 47:215-221 |
| ISSN: | 1432-2161 0364-2348 |
| DOI: | 10.1007/s00256-017-2784-5 |
| Popis: | To evaluate the safety of withholding preprocedure international normalized ratio (INR) and platelet testing in patients undergoing musculoskeletal (MSK) core needle biopsy (CNB).Initially, a retrospective review of 1,162 consecutive patients undergoing MSK CNB with preprocedural INR and platelet testing was performed. Clinical (age, gender, bleeding disorder, liver disease, anticoagulation use, INR 2, platelet count50,000/ul) and biopsy factors (imaging modality, lesion type, biopsy needle gauge, number biopsy samples) were tested for association with bleeding complications. During the second phase, an additional 188 biopsies performed without preprocedural coagulation testing were studied. Categorical variables were compared using Chi-squared or Fisher's exact tests, continuous variables with a student t-test. Multivariate analysis was performed using logistic regression.In the first phase, there was a complication rate of 2.6%, 30/1162. Of the 11 clinical and biopsy factors, soft tissue lesions (p = 0.029) and lesions biopsied under ultrasound (p = 0.048) had a higher rate of bleeding than bone lesions or lesions biopsied under CT, respectively. Only three patients had an INR2, 0.3% (3/1162) and only four patients had platelet count50,000/ul, 0.3% (4/1162). No patient with a bleeding complication had an abnormal preprocedure bleeding test. In the second phase, there was a bleeding complication rate of 1.1% (2/188).Bleeding complications from MSK biopsy are low, even when preprocedure coagulation testing is omitted. |
| Databáze: | OpenAIRE |
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