Is a prolonged bleeding time associated with an increased risk of hemorrhage after liver biopsy?

Bleeding time determination is not advised as a general preoperative hemost asis screening test, but it might be useful in some patient groups. Patient s referred for liver biopsy frequently have coagulation disturbances and ar e at risk of hemorrhage. In this prospective study 219 liver biopsies were carried out regardless of a prolonged bleeding time, but with minimum requi rements far hemoglobin concentration, platelet count, and tests of the inte rnal and external coagulation pathways. The bleeding time was prolonged in the case of 48 (22%) of the biopsies. Significant bleeding as defined by a hemoglobin decrease of greater than or equal to 2.0 g/dl occurred in nine p atients. Three of these patients were bone marrow transplanted. Patients wi th a prolonged bleeding time carried a five times higher risk of bleeding ( adds ratio = 5.0; confidence interval = 1.1-21.8; p = 0.019). We conclude t hat the bleeding time may give additional information on the risk of bleedi ng in same patient groups undergoing liver biopsy.