ULTRASOUND-GUIDED LIVER-BIOPSY FOR PARENCHYMAL LIVER-DISEASE - AN ECONOMIC-ANALYSIS

The use of ultrasound (US) to assist in liver biopsy for nonfocal live r disease has been shown to significantly decrease the incidence of mi nor complications (defined as pain requiring treatment, hypotension, o r bleeding). Ln this study, decision analysis was used to estimate the average additional net charge for US guidance. The risks for minor an d major complications were extracted from the literature. The incidenc e of minor complications such as pain and bleeding not requiring hospi talization has been reported as 49% for blind liver biopsy and 39% for US-guided liver biopsy. Major complications requiring hospital admiss ion occur in 4% of blind liver biopsies and 2% of US-guided liver biop sies. A decision tree was used to calculate the total charges of liver biopsy and its associated complications. The charge for treating an e pisode of minor complications was estimated at $605. The charge relate d to an episode of major complications was estimated at $1533. The tot al charge for an ultrasound-guided liver biopsy (except the added char ge for the use of ultrasound) was $1770, or $102 less than the same ch arge for blind liver biopsy. The addition of ultrasound in performing liver biopsies for diffuse parenchymal liver disease is cost-saving if the additional charge of US is less than $102.