J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 9, Number 2, February 2017, pages 92-97

Computerized Tomography-Guided Paracentesis: An Effective Alternative to Bedside Paracentesis?

Figure 1. Correlation between volume of ascetic fluid (mL) and hospital length of stay (P < 0.0001; 95% CI of slope -0.001398 to -0.0007311; R² = 0.07076).

**Table 1.** Baseline Characteristics of CT-Guided Paracentesis Group and Bedside Paracentesis Group
Characteristic	Bedside paracentesis	CT-guided paracentesis	P value
^†MELD scoring is a system for assessing the severity of chronic liver disease and is calculated by the formula: MELD = 3.78(Ln serum bilirubin (mg/dL)) + 11.2(Ln INR) + 9.57(Ln serum creatinine (mg/dL)) + 6.43. ^¶NSBB: non-selective beta blockers. ^‡P < 0.05 was considered statistically significant.
Age (years), mean ± SD	57.45 ± 10.11	58 ± 11	0.55
Race
African American	126 (46.3)	112 (45.3)	0.86
Hispanics	144 (52.9)	134 (54.2)	0.79
Others	2 (0.73)	1 (0.4)	1
Male sex, no. (%)	195 (71.7)	137 (55.3)	0.0002^‡
MELD^† score, mean ± SD	18.79 ± 7.55	20.99 ± 7.25	0.0006^‡
Medications, no. (%)
Lactulose	196 (72)	188 (76)	0.31
NSBB^¶	146 (53.7)	136 (57.02)	0.79
Aspirin	82 (30.1)	69 (27.9)	0.62
Plavix	9 (0.03)	4 (0.016)	0.26

Table 1. Baseline Characteristics of CT-Guided Paracentesis Group and Bedside Paracentesis Group

Characteristic

Bedside paracentesis

CT-guided paracentesis

P value

^†MELD scoring is a system for assessing the severity of chronic liver disease and is calculated by the formula: MELD = 3.78(Ln serum bilirubin (mg/dL)) + 11.2(Ln INR) + 9.57(Ln serum creatinine (mg/dL)) + 6.43. ^¶NSBB: non-selective beta blockers. ^‡P < 0.05 was considered statistically significant.

Age (years), mean ± SD

57.45 ± 10.11

58 ± 11

0.55

Race

African American

126 (46.3)

112 (45.3)

0.86

Hispanics

144 (52.9)

134 (54.2)

0.79

Others

2 (0.73)

1 (0.4)

Male sex, no. (%)

195 (71.7)

137 (55.3)

0.0002^‡

MELD^† score, mean ± SD

18.79 ± 7.55

20.99 ± 7.25

0.0006^‡

Medications, no. (%)

Lactulose

196 (72)

188 (76)

0.31

NSBB^¶

146 (53.7)

136 (57.02)

0.79

Aspirin

82 (30.1)

69 (27.9)

0.62

Plavix

9 (0.03)

4 (0.016)

0.26

**Table 2.** Outcomes in CT-Guided Paracentesis Group and Bedside Paracentesis Group
Variable	Bedside paracentesis	CT-guided paracentesis	P value
^†Therapeutic paracenteses only. Diagnostic paracenteses were excluded. ^†P < 0.05 was considered statistically significant. ^ΩDefined as drop in hemoglobin by 1 g/dL or local complications like hematoma formation. ^€Defined as positive ascitic fluid (removed with either of the therapeutic procedures) bacterial cultures after an initial negative culture result during same admission (thus ruling out SBP). ^¥Defined as absolute increase of ≥ 0.3 mg/dL in serum creatinine concentration or a ≥ 50% increase in the serum creatinine concentration within 48 h of procedure.
Volume of fluid removed (L), mean ± SD	2.15 ± 2.06	3.54 ± 2.61	0.0001^‡
Patients requiring repeat Paracentesis^† within 1 year, no. (%)	144 (52.9)	130 (52.6)	0.86
Interval between successive paracenteses^† in days (no. of patients), mean ± SD	38.69 ± 33.72 (144)	53.88 ± 50.03 (130)	0.0032^‡
Length of hospital stay, mean ± SD	12.24 ± 8.54	10.49 ± 9.97	0.0318^‡
Complications, no. (%)
Bleeding^Ω	4 (1.4)	0 (0)	0.12
Infections^€	1 (0.36)	4 (1.6)	0.19
Bowel perforation	0 (0)	0 (0)	1.00
ARF^¥	2 (0.008)	3 (0.01)	1.00
Deaths due to the procedure	0 (0)	0 (0)	1.00
Deaths in index admission, no. (%)	20 (8.26)	12 (4.85)	0.28
Discharge diuretic dose, mg
Spironolactone (no. of patients), mean ± SD	83.5 ± 53.4 (250)	64.80 ± 60.13 (234)	0.0003^‡
Furosemide (no. of patients), mean ± SD	48 ± 26.05 (124)	44.55 ± 38.14 (101)	0.42

Table 2. Outcomes in CT-Guided Paracentesis Group and Bedside Paracentesis Group

Variable

Bedside paracentesis

CT-guided paracentesis

P value

^†Therapeutic paracenteses only. Diagnostic paracenteses were excluded. ^†P < 0.05 was considered statistically significant. ^ΩDefined as drop in hemoglobin by 1 g/dL or local complications like hematoma formation. ^€Defined as positive ascitic fluid (removed with either of the therapeutic procedures) bacterial cultures after an initial negative culture result during same admission (thus ruling out SBP). ^¥Defined as absolute increase of ≥ 0.3 mg/dL in serum creatinine concentration or a ≥ 50% increase in the serum creatinine concentration within 48 h of procedure.

Volume of fluid removed (L), mean ± SD

2.15 ± 2.06

3.54 ± 2.61

0.0001^‡

Patients requiring repeat Paracentesis^† within 1 year, no. (%)

144 (52.9)

130 (52.6)

0.86

Interval between successive paracenteses^† in days (no. of patients), mean ± SD

38.69 ± 33.72 (144)

53.88 ± 50.03 (130)

0.0032^‡

Length of hospital stay, mean ± SD

12.24 ± 8.54

10.49 ± 9.97

0.0318^‡

Complications, no. (%)

Bleeding^Ω

4 (1.4)

0 (0)

0.12

Infections^€

1 (0.36)

4 (1.6)

0.19

Bowel perforation

0 (0)

1.00

ARF^¥

2 (0.008)

3 (0.01)

1.00

Deaths due to the procedure

0 (0)

1.00

Deaths in index admission, no. (%)

20 (8.26)

12 (4.85)

0.28

Discharge diuretic dose, mg

Spironolactone (no. of patients), mean ± SD

83.5 ± 53.4 (250)

64.80 ± 60.13 (234)

0.0003^‡

Furosemide (no. of patients), mean ± SD

48 ± 26.05 (124)

44.55 ± 38.14 (101)

0.42