Early discharge after core liver biopsy: is it safe and cost-effective?
OBJECTIVE
To determine if ambulatory patients who have undergone image-guided core liver biopsy with an 18-gauge needle and spring-loaded biopsy gun can be safely discharged after 1 hour of observation in the radiology department.


METHODS
Fifty-four consecutive patients underwent ultrasound-guided core liver biopsy for a variety of suspected diffuse liver diseases. Post-biopsy, they were asked to grade their pain on a scale of 1-10 after 1 hour of recumbency on a hospital gurney in the department. At 2 weeks, all patients were contacted and asked about their level of pain and when they returned to normal activities.


RESULTS
Of the 54 patients enrolled, 4 were lost to follow-up. Pain was the most common minor complication, occurring in 31 (62%) of patients. The average level of pain after 1 hour was 2.1 (1 = no pain) and after 24 hours, 1.5. Seven patients were admitted to a medical daycare bed for a total of 4 hours and were then discharged. The remainder were discharged after 1 hour. Forty (80%) patients were pain-free after 24 hours, 36 (90%) of the 40 patients who were working returned to work the following day, and within a week, all patients had returned to all normal activities. No patients required an inpatient hospital stay or sought assistance at an emergency department.


CONCLUSIONS
These preliminary results demonstrate that ultrasound-guided 18-gauge liver core biopsy is a safe procedure, and, provided larger series confirm these findings, patients showing no complications can be discharged from the department after 1 hour with notable cost savings.
Bicknell
Simon G
SG
Department of Radiology, University of British Columbia, Vancouver, BC.
Richenberg
Jonathon
J
Cooperberg
Peter L
PL
Tiwari
Pari
P
Halperin
Laurence
L
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000554:Ambulatory Care Facilities; D001707:Biopsy, Needle / Q000191:economics / Q000295:instrumentation; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012449:Safety; D016896:Treatment Outcome