• Watsamon Uraiwan and Pirun Saelue.
• Hematology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand.
• Ann. Med. 2025 Dec 1; 57 (1): 24530882453088.

IntroductionBleeding from the affected organs is a common manifestation of amyloidosis. The risk for perioperative bleeding in patients with amyloidosis remains controversial. In this study, we aimed to compare the bleeding risk of tissue biopsies for a definitive diagnosis between patients with and without amyloidosis, identify risk factors, and generate a prediction model for bleeding risk in these patients.MethodsWe enrolled patients aged >15 years who had amyloidosis as part of their differential diagnosis before tissue biopsy. After obtaining histopathological reports, we randomly selected patients with and without amyloidosis at a ratio of 4:1.ResultsA total of 360 patients were enrolled before tissue biopsy. Bleeding complications were observed in 5.6% and 4.2% of patients with and without amyloidosis, respectively. Amyloidosis was not associated with an increased perioperative bleeding risk (adjusted odds ratio 1.19; 95% confidence interval 0.17-8.41, p = 0.859). Kidney biopsy was a significant risk factor for perioperative bleeding in tissue biopsies. A KiHPL model was generated to predict the bleeding risk. The area under the curve was 0.87, with a good calibration plot for this model.ConclusionsAmyloidosis is not associated with an increased risk of bleeding in tissue biopsies. The KiHPL model can predict the bleeding risk of tissue biopsies for a definitive diagnosis in patients with suspected amyloidosis.

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