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Ethnicity influences pain after ultrasound-guided percutaneous liver biopsy

Mahadeva, Sanjiva; Mahfudz, Anis S.c; Vijayananthan, Anushyab

European Journal of Gastroenterology & Hepatology: December 2015 - Volume 27 - Issue 12 - p 1378–1381
doi: 10.1097/MEG.0000000000000465
Original Articles: Liver Disease: Diagnosis and Prediction

Background The influence of ethnicity on pain complicating ultrasound-guided percutaneous liver biopsy (US-guided PLB) and its clinical impact has not been reported to date.

Methods Consecutive adults from a multiethnic background, undergoing an US-guided PLB, were independently assessed for pain up to 6 h after the procedure. Clinical and demographic parameters were analysed to determine independent predictors of significant pain after PLB. Willingness to undergo a repeat procedure was assessed 1 week after PLB.

Results Data from 203 patients (median age 50 years; 43.9% female; ethnicity: Malay 41.5%, Chinese 40%, Indian 18%; median BMI 27.7 kg/m2; median waist circumference 92.0 cm) were analysed. Pain after US-guided PLB was experienced in 133 (61.1%) patients, with severity grades as follows: none, n=81 (39.9%); mild, n=56 (27.6%); moderate, n=51 (25.1%); and severe, n=15 (7.4%). Analgesia requirements correlated well with severity of pain. Independent predictors of significant pain after PLB (moderate and severe categories) in patients included age less than 50 years [odds ratio (OR) 3.0], female sex (OR 3.7), Indian ethnicity (OR 2.9) and Malay ethnicity (OR 2.7), but not number of needle passes, BMI and educational levels. Patients who experienced moderate/severe pain were less willing to undergo a repeat PLB compared with those who experienced mild/no pain (60.9 vs. 82.8%, P=0.001).

Conclusion Ethnicity has an important role in the development of pain after US-guided PLB. This has a significant impact on willingness to repeat the procedure.

Departments of aMedicine

bRadiology, Faculty of Medicine, University Malaya, Kuala Lumpur

cMedical Imaging Unit, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia

Correspondence to Sanjiv Mahadeva, MBBS, MRCP, Department of Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia Tel: +603 7949 2299; fax: +603 7949 2950; e-mail:

Received July 4, 2015

Accepted July 29, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.