ICU sedation, delirium & recovery
Diagnostic yield and adverse events of liver biopsy in intensive-care-unit patients: a multicenter retrospective observational cohort study
Authors' conclusion
In ICU patients, liver biopsy provides a wide range of diagnoses and guides treatment decisions. However, the risk of potentially fatal bleeding is a major concern.
Study context
- Population
- Consecutive adults in 4 French intensive-care-unit (ICUs) who had a liver biopsy during the ICU stay, 2006–2023route missing n = 11
- Participants
- 139 adults
- Exposure
- Transjugular vs Percutaneous vs Laparoscopic
- Transjugularn = 97
- Percutaneousn = 30
- Laparoscopicn = 1
- Outcome
- Diagnostic yield and therapeutic implications of liver biopsy
Methodological detailsmulticentre, observational
- Multicentre
- Observational
Main finding
As reported in the abstract
- Liver parenchyma evaluable
- 137/139 (99%)
- Histological diagnoses in total
- 187
- Pathological diagnoses matched pre-biopsy hypotheses
- 83 (60%)
- Chronic or acute-on-chronic liver disease
- n = 78, 56%
- Malignancy
- n = 27, 19%
- Infectious disease
- n = 12, 9%
- Other diagnoses (mainly drug toxicity and biliary diseases)
- n = 17, 12%
- Therapeutic implications
- 80 (58%)
- New treatment, among those with therapeutic implications
- 66 (82%)
- Continued on empirically initiated treatment
- 7 (9%)
- Taken off previous treatment
- 7 (9%)
Observational data: associations, not effects.
Further findings
Day-90 survival, with vs without therapeutic implications of biopsy
- Not significantly different
Safety
- WHO grade 3-4 bleeding
- 10 (7%)
- Fatal bleeding
- 2
- Higher severity scores, higher urea and absence of cirrhosis associated with greater bleeding risk
Original publication
Diagnostic yield and adverse events of liver biopsy in intensive-care-unit patients: a multicenter retrospective observational cohort study. Ann Intensive Care. Published 26 August 2025. doi:10.
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