Analysis of Risk Factors of Bleeding Complications in Percutaneous Needle Biopsy of Liver Occupying Lesions

PURPOSE: To search for risk factors for bleeding complications after percutaneous biopsy of primary or secondary space-occupying lesions of liver guided by imaging. METHODS: Consecutive 555 patients with liver space-occupying lesions who underwent ultrasound or CT-guided percutaneous biopsy in our hospital from January 2015 to January 2021 were retrospectively analyzed. Those who cannot cooperate with breath-holding and cannot successfully complete the operation, cytology, and incomplete clinical data. After screening, a total of 502 patients were enrolled, including 313 males and 189 females. Abdominal cavity or liver subcapsular hemorrhage after procedure was used as the dependent variable, and patient’s gender, age, pathological results, tumor size, preoperative platelets and international normalized ratio (INR) and hemoglobin as independent variables. All independent variables were analyzed by a single factor logistic regression analysis. The independent variables with P<0.05 were included in the regression model and analyzed by multivariate logistic regression analysis to search for the risk factors for bleeding complications of liver space-occupying lesions. RESULTS: A total of 502 patients with liver space-occupying lesions undergoing percutaneous liver biopsy guided by imaging equipment were included. Twenty-six of 502 (5.2%) patients occurred abdominal cavity or liver sub-capsule bleeding after procedure. Univariate logistic regression analysis observed that liver cirrhosis, the number of punctured tissues and the depth of puncture were related to bleeding complications after puncturing. Multivariate logistic regression analysis showed that liver cirrhosis and puncture depth were risk factors for bleeding complications (P<0.05). The ROC curve for predicting bleeding complications after needle biopsy in patients with liver cirrhosis has a sensitivity of 94.3% and a specificity of 46.2%. CONCLUSION: Liver cirrhosis and puncture depth are risk factors for bleeding complications during percutaneous biopsy of liver occupying lesions.