Hospitalist service successfully performed bone marrow aspiration and biopsies

A hospitalist procedure service was able to routinely perform bone marrow aspiration and biopsies, a new study reported.

In 2015 and 2016, hospitalist faculty members on a tertiary care center's bedside procedure team were trained to do bone marrow aspiration and biopsy by the oncology department. The current study reported internally collected data from the service's performance of the procedures in 2016 to 2021. Results were published by the Journal of Hospital Medicine on Oct. 13.

The procedure service performed a total of 432 bone marrow aspiration and biopsies, 46 of which (10.6%) were unsuccessful and required referral for CT guidance. The most common reason for lack of success was the patient's inability to tolerate the procedure without sedation, which the service was not credentialed to provide. There was one complication, a retroperitoneal hematoma requiring transfusion (0.2%), and authors noted this was similar to the complication rate found in the literature (around 0.1%). Eighty-eight of the patients (20.4%) had elevated bleeding risk. Trainees assisted in 62 (14.4%) of the procedures.

The provision of bone marrow aspiration and biopsy by hospitalists has “allowed us to expand our procedural experience and billing while providing the patient with a comfortable bedside experience and avoiding unnecessary radiation,” said the study authors, noting that 40% of the patients who were treated by the procedure service were primary medicine patients, rather than oncology patients.

“With good success rates and low complications, patients are able to have their [bone marrow aspiration and biopsies] done at the bedside in an expedited manner without the need for specialist-level services and learners are able to gain exposure to a commonly required procedure,” they wrote.