PMID- 35504435
OWN - NLM
STAT- MEDLINE
DCOM- 20220802
LR  - 20220821
IS  - 1535-7732 (Electronic)
IS  - 1051-0443 (Linking)
VI  - 33
IP  - 8
DP  - 2022 Aug
TI  - Risk Factors for Hemorrhagic Adverse Events in Percutaneous Transhepatic Biliary 
      Drainage: A Prospective Multicenter Study.
PG  - 919-925.e2
LID - S1051-0443(22)00833-8 [pii]
LID - 10.1016/j.jvir.2022.04.032 [doi]
AB  - PURPOSE: To determine risk factors (RFs) for hemorrhagic adverse events (AEs) 
      associated with percutaneous transhepatic biliary drainage (PTBD) and to develop 
      a risk assessment model. MATERIALS AND METHODS: This was a multicenter, 
      prospective, case control study between 2015 and 2020. Adults with an indication 
      for PTBD were included. Patients who had undergone recent previous drainage 
      procedures were excluded. Multiple variables were controlled. The exposure 
      variables were the number of capsular punctures and passes (using the same 
      puncture). A multivariate analysis was performed (logistic regression analysis). 
      RESULTS: A total of 304 patients (mean age, 63 years +/- 14 [range, 23-87 years]; 
      female, 53.5%) were included. Hemorrhagic AEs occurred in 13.5% (n = 41) of the 
      patients, and 3.0% (n = 9) of the cases were severe. Univariate analysis showed 
      that the following variables were not associated with hemorrhagic AEs: age, sex, 
      bilirubin and hemoglobin levels, type of pathology, portal hypertension, location 
      of vascular punctures, ascites, nondilated bile duct, intrahepatic tumors, 
      catheter features, blood pressure, antiplatelet drug use, and tract embolization. 
      Multivariate analysis showed that number of punctures (odds ratio [OR], 2.5; P = 
      .055), vascular punctures (OR, 4.1; P = .007), fatty liver or cirrhosis (OR, 3.7; 
      P = .021), and intrahepatic tumor obstruction (Bismuth >/= 2; OR, 2.4; P = .064) 
      were associated with hemorrhagic AEs. Patients with corrected coagulopathies had 
      fewer hemorrhagic AEs (OR, -5.5; P = .026). The predictability was 88.2%. The 
      area under the curve was 0.56 (95% confidence interval, 0.50-0.61). CONCLUSIONS: 
      Preprocedural and intraprocedural RFs were identified in relation to hemorrhage 
      with PTBD. AE risk assessment information may be valuable for prediction and 
      management of hemorrhagic AEs.
CI  - Copyright (c) 2022 SIR. Published by Elsevier Inc. All rights reserved.
FAU - Houghton, Eduardo Javier
AU  - Houghton EJ
AD  - Division of Surgery, DAICIM Foundation, Buenos Aires, Argentina; Division of 
      Surgery, Minimally Invasive Surgery, Hospital Bernardino Rivadavia, Ciudad 
      Autonoma de Buenos Aires, Argentina; Division of Surgery, University of Buenos 
      Aires, Buenos Aires, Argentina. Electronic address: ehoughton26@icloud.com.
FAU - Uribe, Ana Karla
AU  - Uribe AK
AD  - Division of Surgery, DAICIM Foundation, Buenos Aires, Argentina.
FAU - De Battista, Jose Manuel
AU  - De Battista JM
AD  - Division of Surgery, Rodolfo Rossi Hospital, La Plata, Argentina.
FAU - Finger, Caetano
AU  - Finger C
AD  - Division of Surgery, DAICIM Foundation, Buenos Aires, Argentina.
FAU - Acquafresca, Pablo
AU  - Acquafresca P
AD  - Division of Surgery, DAICIM Foundation, Buenos Aires, Argentina.
FAU - Palermo, Mariano
AU  - Palermo M
AD  - Division of Surgery, DAICIM Foundation, Buenos Aires, Argentina; Division of 
      Surgery, University of Buenos Aires, Buenos Aires, Argentina.
FAU - Gimenez, Mariano E
AU  - Gimenez ME
AD  - Division of Surgery, DAICIM Foundation, Buenos Aires, Argentina; Division of 
      Surgery, University of Buenos Aires, Buenos Aires, Argentina; Division of 
      Surgery, Percutaneous Surgery, IHU IRCAD, University of Strasbourg, France.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220430
PL  - United States
TA  - J Vasc Interv Radiol
JT  - Journal of vascular and interventional radiology : JVIR
JID - 9203369
SB  - IM
MH  - Adult
MH  - Case-Control Studies
MH  - *Drainage/adverse effects/methods
MH  - Female
MH  - *Hemorrhage/etiology
MH  - Humans
MH  - Middle Aged
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2022/05/04 06:00
MHDA- 2022/08/03 06:00
CRDT- 2022/05/03 19:25
PHST- 2021/10/21 00:00 [received]
PHST- 2022/03/29 00:00 [revised]
PHST- 2022/04/21 00:00 [accepted]
PHST- 2022/05/04 06:00 [pubmed]
PHST- 2022/08/03 06:00 [medline]
PHST- 2022/05/03 19:25 [entrez]
AID - S1051-0443(22)00833-8 [pii]
AID - 10.1016/j.jvir.2022.04.032 [doi]
PST - ppublish
SO  - J Vasc Interv Radiol. 2022 Aug;33(8):919-925.e2. doi: 10.1016/j.jvir.2022.04.032. 
      Epub 2022 Apr 30.