Cirrhosis Is a Predictor of Adverse Events in Endoscopic Ultrasound Fine-Needle Aspiration: A Propensity-Score Analysis.

Published on Jan 1, 2020in Digestive Diseases2.493
· DOI :10.1159/000501268
Antonio Facciorusso19
Estimated H-index: 19
(University of Foggia),
Vincenzo Rosario Buccino7
Estimated H-index: 7
(University of Foggia)
+ 2 AuthorsNicola Muscatiello22
Estimated H-index: 22
(University of Foggia)
Sources
Abstract
BACKGROUND: Cirrhotic patients are at increased risk of adverse events (AEs) after invasive procedures. However, the safety profile of endoscopic ultrasound (EUS) fine-needle aspiration in cirrhotic patients is still unknown. OBJECTIVES: To examine the AEs rate after EUS fine-needle aspiration in cirrhotic patients as compared to a control group of noncirrhotic patients. METHODS: Out of 735 patients with suspected abdominal lesions referred to our center between 2006 and 2018, after propensity-score matching, 2 groups were compared: 95 cirrhotics and 95 controls. Primary variables included rate of overall and serious AEs. Secondary endpoint was incidence of acute-on-chronic liver failure. RESULTS: Median age was 64 years, and pancreatic lesions represented the sampled tissue in 57 patients (60%) in each group (p = 1.0) with mean size of 22 mm in both cohorts (p = 0.3). Overall, 20 AEs (21%) of which 9 serious (9.4%) were observed in cirrhotic patients and 3 (3.1%) mild events were experienced by noncirrhotic subjects. Only liver cirrhosis was confirmed as a significant predictor of AEs in multivariate analysis (OR 8.11, 2.34-28; p = 0.001). Overall rate of infections was 6/95 (6.3%), of which 4 were serious (4.2%) in cirrhotics and 1/95 (1%) in the control group (p = 0.05). All serious infections led to the occurrence of acute-on-chronic liver failure. Minor bleeding events were more frequent in cirrhotic patients (4.2 vs. 0%; p = 0.04). CONCLUSIONS: The rate of AEs after EUS fine-needle aspiration is higher in cirrhotic patients, and acute-on-chronic liver failure may represent a serious complication of this procedure.
📖 Papers frequently viewed together
8 Citations
3 Citations
20207.34Endoscopy
1 Citations
References0
Newest
Cited By4
Newest
#1Antonio FacciorussoH-Index: 19
#2Nicola MuscatielloH-Index: 22
Source
#1Antonio FacciorussoH-Index: 19
#2Antonio TurcoH-Index: 2
Last. Nicola MuscatielloH-Index: 22
view all 6 authors...
In spite of promising preliminary results, evidence supporting the use of non-anesthesiologist-administered propofol sedation (NAAP) in endoscopic ultrasound (EUS) procedures is still limited. The aim of this manuscript was to examine the safety and efficacy of NAAP as compared to anesthesiologist-administered propofol sedation in EUS procedures performed in a referral center. Out of 832 patients referred to our center between 2016 and 2019, after propensity score matching two groups were compar...
Source
Important advancements in endoscopic ultrasound-guided tissue sampling techniques and development of new needle designs have improved the diagnostic yield of pancreatic lesions. This innovation in endoscopic ultrasound has also opened the door for early diagnosis and precision therapy in the management of cancer patients. Endoscopic ultrasound fine needle biopsy is an invaluable tool and newer biopsy designs will probably play a pivotal role in the management of pancreatic lesions in the next fu...
3 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Vincenzo Rosario Buccino (University of Foggia)H-Index: 7
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
view all 6 authors...
ABSTRACT Background Basic and clinical studies suggest that statins may prevent and even ameliorate acute pancreatitis. The present study was to evaluate whether statin decreases the risk of acute pancreatitis in patients undergoing endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts. Methods Out of 456 patients with pancreatic cysts referred to our center between 2006 and 2018, 365 were finally included in analyses: 86 were treated with statins and 279 were not at the time o...
7 CitationsSource