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Association between Administration of Antithrombotics and Intraperitoneal Hemorrhage in Patients Undergoing
Akira Asai1, Keisuke Yokohama1, Hideko Ohama1
12nd Department of Internal Medicine, Osaka Medical College, Takatsuki 5698686, Japan.
Insights
Antithrombotic drugs did not increase the risk of intraperitoneal hemorrhage in liver disease patients undergoing percutaneous interventions. Discontinuing these medications, as per guidelines, appears safe for these procedures.
Area of Science:
- Hepatology
- Interventional Radiology
- Clinical Medicine
Background:
- Percutaneous interventions are vital for liver disease diagnosis and treatment.
- Intraperitoneal hemorrhage is a common complication of these procedures.
- Increasing use of antithrombotics in liver disease patients raises safety concerns.
Purpose of the Study:
- To evaluate risk factors for intraperitoneal hemorrhage after percutaneous interventions in liver disease patients.
- To assess the influence of antithrombotic drug administration on hemorrhage risk.
Main Methods:
- Retrospective cohort study of 1025 liver disease patients undergoing percutaneous interventions (April 2015-March 2020).
- Ultrasound-guided procedures with hemorrhage detection via computed tomography.
- Propensity score matching used to compare groups receiving antithrombotics versus those not.
Main Results:
- Nine patients (0.88%) experienced intraperitoneal hemorrhage, none severe.
- No significant difference in hemorrhage risk was found based on antithrombotic administration (p=0.1961).
- Antithrombotics were not identified as a risk factor for hemorrhage in interventional treatment or liver biopsy groups post-matching.
Conclusions:
- Antithrombotic administration does not appear to be a significant risk factor for intraperitoneal hemorrhage after percutaneous interventions in liver disease patients.
- Discontinuing antithrombotics according to guidelines may not increase hemorrhage risk.
- Further research may explore specific antithrombotic agents and intervention types.
Abstract:
Currently, percutaneous interventions are essential for diagnosis and treatment of liver diseases. The most frequent complication of percutaneous interventions is intraperitoneal hemorrhage. Recently, the number of patients with liver diseases on antithrombotics has been increasing. This retrospective cohort study aimed to evaluate the risk factors for intraperitoneal hemorrhage in patients after percutaneous interventions for liver diseases. This study included 1025 patients who underwent percutaneous interventions for liver diseases from April 2015 to March 2020. All interventions were performed using an ultrasound-guided approach. The influence of antithrombotic drug administration in patients, who underwent percutaneous interventions according to the guidelines for the American Association for the Study of Liver Disease, was evaluated. Intraperitoneal hemorrhage after percutaneous interventions was detected by computed tomography. Intraperitoneal hemorrhage occurred in nine patients (0.88%); however, these adverse events were not severe. We compared clinical characteristics between the patients with and without intraperitoneal hemorrhage. Although, there was no difference based on the administration of antithrombotics (p = 0.1961), seven of nine patients who showed intraperitoneal hemorrhage received percutaneous treatments (radio frequency ablation or microwave ablation). Therefore, we divided patients who underwent treatments and liver biopsy and then investigated the influence of antithrombotics on the intraperitoneal hemorrhage. After propensity score matching in each patient group, the administration of antithrombotics was not identified as a risk factor for hemorrhage in patients who underwent interventional treatments and patients who underwent liver biopsy. When the antithrombotics were discontinued, according to the guidelines, it may not increase the risk factor for hemorrhage in patients of liver disease who underwent percutaneous interventions.
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