Utilization rates, complications and costs of percutaneous liver biopsy: a population-based study in

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Liver International 28 (5) , 705–712 doi:10.1111/j.1478-3231.2008.01691.x

Abstract

CLINICAL STUDIES

Utilization rates, complications and costs of percutaneous liver biopsy: a

population-based study including 4275 biopsies

P. Myers11 Department of Medicine, Division of Gastroenterology, Liver

Unit, University of Calgary, Calgary, AB, Canada,, Fong22 Health System

Analysis Unit; Quality, Safety and Health Information, Calgary Health Region,

Calgary, AB, Canada and Abdel Aziz M. Shaheen11 Department of Medicine, Division

of Gastroenterology, Liver Unit, University of Calgary, Calgary, AB, Canada,1

Department of Medicine, Division of Gastroenterology, Liver Unit, University of

Calgary, Calgary, AB, Canada,

2 Health System Analysis Unit; Quality, Safety and Health Information, Calgary

Health Region, Calgary, AB, Canada

Correspondence

Dr P. Myers, Liver Unit, University of Calgary, 6022, Teaching Research

and Wellness Building 3330 Hospital Drive N.W., Calgary, AB, Canada T2N 4N1

Tel: +403 592 5049

Fax: +403 592 5090

e-mail: rpmyers@...

AHCIP, Alberta Health Care Insurance Plan; CHR, Calgary Health Region; CI,

confidence interval; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; INR,

international normalized ratio; IQR, interquartile range; NAFLD, nonalcoholic

fatty liver disease; RR, rate ratio; SES, socioeconomic status.

Abstract

Background: Liver biopsy is an important tool in the management of patients with

liver disease. Because biopsy practices may be changing, we studied patterns of

use in a large Canadian Health Region. We aimed to describe trends in biopsy

utilization and the incidence and costs of complications from a population-based

perspective.

Methods: Administrative databases were used to identify percutaneous liver

biopsies performed between 1994 and 2002. Significant complications were

identified by reviewing medical records of patients hospitalized within 7 days

of a biopsy and those with a diagnostic code indicative of a procedural

complication. Analyses of biopsy rates employed Poisson regression.

Results: Between 1994 and 2002, 3627 patients had 4275 liver biopsies (median 1

per patient; range 1–12). Radiologists performed the majority (90%),

particularly during the latter years (1994 vs. 2002: 73 vs. 98%; P

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