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Retrospective evaluation of routine in-hospital observation in 433 patients after CT-guided biopsies

Tim Fischer, Yassir El Baz, Simon Wildermuth, Sebastian Leschka, Sabine Guesewell, Paul Martin Putora & Tobias Dietrich

abstract

BACKGROUND
After computed tomography (CT)-guided interventions, routine in-hospital observation is recommended by the Cardiovascular and Interventional Radiological Society of Europe.

PURPOSE
To evaluate the frequency of delayed major complications or hospitalizations after CT-guided biopsies in patients with initially no or minor complications and to assess whether routine in-hospital observation is justified.

MATERIAL AND METHODS
This retrospective study included 433 outpatients after CT-guided biopsy of the thoracic (n = 176), abdominal (n = 129), or musculoskeletal (n = 128) region with subsequent in-hospital observation. Complications were graded according to the current Society of Interventional Radiology recommendations and grouped into minor or major. A complication that occurred during in-hospital observation was defined as delayed complication. A delayed major complication was a newly developed major complication or a progression from an initially minor to a major complication. Hospitalization frequencies were evaluated similarly. Occurrence, 95% confidence intervals (CI), and values for significant differences between the three organ groups were calculated. If delayed major complications were more frequent than 1%, routine in-hospital observation was considered justified.

RESULTS
Delayed, major complication frequencies were: thoracic, 8.2% (95% CI 4.6-13.4); abdominal, 0.0% (95% CI 0.0-2.9); and musculoskeletal, 0.0% (95% CI 0.0-2.9) ( < 0.001). Delayed hospitalization frequencies were: thoracic, 8.8% (95% CI 5.0-14.2); abdominal, 1.6% (95% CI 0.2-5.6); and musculoskeletal, 0.0% (95% CI 0.0-2.9) ( < 0.001).

CONCLUSION
After thoracic interventions, routine observation is considered justified for patient safety whereas routine observation may be omitted after musculoskeletal interventions. In the abdominal group, no delayed complications were observed, but delayed hospitalization occurred. Thus, in-hospital observation could be justified in a safe patient environment, but remains an individual decision.
   
citation Fischer T, El Baz Y, Wildermuth S, Leschka S, Guesewell S, Putora P M, Dietrich T. Retrospective evaluation of routine in-hospital observation in 433 patients after CT-guided biopsies. Acta Radiol 2021;2841851211011564.
   
type journal paper/review (English)
date of publishing 03-05-2021
journal title Acta Radiol
ISSN electronic 1600-0455
pages 2841851211011564
PubMed 33940960
DOI 10.1177/02841851211011564