Premium
Determinants of Positive Temporal Artery Biopsies in the Veterans Health Administration National Database Cohort
Author(s) -
Chung Sarah H.,
Morcos Meredith B.,
Ng Bernard
Publication year - 2020
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23897
Subject(s) - medicine , odds ratio , confidence interval , cohort , biopsy , logistic regression , retrospective cohort study , database , veterans affairs , prednisone , surgery , computer science
Objective This study sought to determine the effect of temporal artery biopsy ( TAB ) postfixation length, laterality, age, and prior prednisone exposure on TAB positivity utilizing the Veterans Health Administration national database. Methods Subjects with procedure code for TAB between 1999 and 2017 were queried, and pathology reports were reviewed manually. Demographic, laboratory, and prescription data were extracted. Multivariate analyses and logistic regression were run using Stata, version 13.0. Results A total of 3,057 pathology reports were reviewed; 306 biopsies (10%) were designated positive. The likelihood of a positive TAB significantly correlated with TAB postfixation length of >3.0 cm (odds ratio [ OR ] 1.58 [95% confidence interval (95% CI ) 1.06, 2.36], P < 0.05) as well as with bilateral biopsy in 1 sitting ( OR 1.83 [95% CI 1.29, 2.59], P < 0.01). Positive TAB also significantly correlated with age >71 years. Prednisone administration up to and beyond 42 days prior to TAB did not influence TAB result. Conclusion This retrospective study examined predictors of TAB positivity and utilized national data collected on US veterans over the span of 18 years. The results suggest consideration of pursuing initial bilateral TAB or achieving a TAB postfixation length of at least 3 cm to improve yield. The results also agree with prior studies showing that pre‐ TAB steroid exposure does not appear to affect yield even up to and beyond 42 days prior to biopsy.