Highest 3-month international normalized ratio (INR): a predictor of bleeding following ultrasound-guided liver biopsy

ConclusionThe highest INR in 3  months preceding ultrasound-guided percutaneous liver biopsy is associated with, and a better predictor for, post-procedural bleeding than the most recent INR and should be considered in patient risk stratification.Clinical relevance statementDespite correction of coagulopathic indices, the highest international normalized ratio within the 3  months preceding percutaneous liver biopsy is associated with, and a better predictor for, bleeding and should considered in clinical decision-making and determining biopsy approach.Key Points•Bleeding occurred in 2% of patients following ultrasound-guided liver biopsy, and was non-trivial in 41% of those patients who needed additional intervention and had an associated 23% 30-day mortality rate.•The highest INR within 3  months preceding biopsy (AUC = 0.79) is a better predictor of bleeding than the most recent INR (AUC = 0.61).•The MELD score is associated with post-procedural bleeding, but with variable predictive performance largely driven by its individual laboratory components.
Source: European Radiology - Category: Radiology Source Type: research