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PLoS One. 2017 Dec 13;12(12):e0189347. doi: 10.1371/journal.pone.0189347. eCollection 2017.

Risk factors associated with adverse events during endoscopic ultrasound-guided tissue sampling.

Author information

1
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2
Department of Health Science & Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.
3
Department of Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
4
Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
5
Department of Health, Behavior and Society and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America.
6
Department of Medicine, Yonsei University School of Medicine, Seoul, Korea.
7
Department of Medicine, Inha University School of Medicine, Incheon, Korea.
8
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
9
Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea.
10
Department of Medicine, Chungbuk National University School of Medicine, Cheongju, Korea.
11
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
12
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
13
Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea.
14
Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
15
Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.
16
Department of Medicine, Wonkwang University School of Medicine, Iksan, Korea.
17
Department of Medicine, Konkuk University School of Medicine, Seoul, Korea.
18
Department of Medicine, Chonnam National University School of Medicine, Gwangju, Korea.

Abstract

BACKGROUND AND AIM:

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is commonly used to obtain tissue external to the gastrointestinal tract. EUS-FNA is relatively safe, but occasionally adverse events have been reported. There is scarcity of data on risk factors of adverse events. The aim of this study is to identify risk factors associated with EUS-FNA.

METHODS:

In this multicenter case-control study, we retrospectively reviewed 4,097 cases between 2009 and 2012 at 15 hospitals in Korea. Among the patients there were 104 cases (2.5%) who had adverse events of which 12 (0.29%) were severe. We matched 520 controls (1:5 ratios) stratified by hospital to analyze the potential risk factors.

RESULTS:

The most common adverse events were pancreatitis (45/104, 43.3%) and infection (46/104, 44.2%). Endoscopic retrograde cholangiopancreatography (ERCP) on the same day was a risk factor of all adverse events [OR = 2.41, 95% CI (1.41, 4.12)], pancreatitis [OR = 2.31, 95% CI (1.02, 5.25)], and infection [OR = 2.75, 95% CI (1.31, 5.78)]. More than 15 to-and-fro movements during puncture increased the risk of pancreatitis [OR = 2.30, 95% CI (1.11, 4.77)] and infection [OR = 3.65, 95% CI (1.55, 8.59)]. A higher number of punctures was positively correlated with pancreatitis [OR = 1.34, 95% CI (1.08, 1.67)] but negatively correlated with infection [OR = 0.66, 95% CI (0.48, 0.89)].

CONCLUSIONS:

EUS-FNA is a safe procedure in which serious adverse events are rare. We define some risk factors of adverse events during EUS-FNA, including ERCP on the same day, a higher number of punctures, and more than 15 to-and-fro movements.

PMID:
29236743
PMCID:
PMC5728556
DOI:
10.1371/journal.pone.0189347
[Indexed for MEDLINE]
Free PMC Article

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