Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule: an analysis of discharge records.
Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule: an analysis of discharge records.
复制标题
DOI：
10.7326/0003-4819-155-3-201108020-00003
复制
发表时间：
2011-08-02
影响因子：
39.2
通讯作者：
Welch HG
中科院分区：
文献类型：
--
作者：
Wiener RS;Schwartz LM;Woloshin S;Welch HG
由于在接受胸部计算机断层扫描的患者中发现了高达25%的肺结节，因此是否进行活检的问题变得越来越普遍。经胸肺穿刺活检后并发症的数据仅限于选定机构的病例系列。确定基于人群的肺结节经皮穿刺活检后并发症风险估计。横截面分析。2006年医疗保健成本和利用项目的加州、佛罗里达、密歇根和纽约州门诊手术数据库和州住院病人数据库。15，865例接受肺结节经胸穿刺活检的成人。活检并发出血、任何气胸和需要胸管的气胸的百分比，以及与各种活检特征相关的这些并发症的校正比值比，使用多变量人群平均广义估计方程计算。虽然出血罕见，并发活检1.0%（95% CI 0.9-1.2%），但17.8%（95% CI 11.8-23.8%）的出血患者需要输血。相比之下，任何气胸的风险为15.0%（95% CI 14.0-16.0%），所有活检中有6.6%（95% CI 6.0-7.2%）导致气胸需要胸管。与无并发症的患者相比，发生出血或气胸需要胸管的患者住院时间更长（p<0.001），更可能发生呼吸衰竭需要机械通气（p=0.02）。60-69岁的患者（与年轻或老年患者相反）、吸烟者和慢性阻塞性肺疾病患者并发症的风险更高。如果并发症编码不完整，估计的风险可能不准确。分析的数据库包含很少的临床细节（例如，结节特征、活组织检查病理学）并且不能确定活组织检查是否产生有用的信息。虽然出血是经胸肺穿刺活检的罕见并发症，但气胸很常见，通常需要放置胸管。这些基于人群的数据应该有助于患者和医生在是否对肺结节进行活检时做出更明智的选择。退伍军人事务部和国家癌症研究所K 07 CA 138772
Because pulmonary nodules are found in up to 25% of patients undergoing chest computed tomography, the question of whether to biopsy is becoming increasingly common. Data on complications following transthoracic needle lung biopsy are limited to case series from selected institutions. To determine population-based estimates of risks of complications following transthoracic needle biopsy of a pulmonary nodule. Cross-sectional analysis. The 2006 Healthcare Cost and Utilization Project’s State Ambulatory Surgery Databases and State Inpatient Databases for California, Florida, Michigan, and New York. 15,865 adults who underwent transthoracic needle biopsy of a pulmonary nodule. Percent of biopsies complicated by hemorrhage, any pneumothorax, and pneumothorax requiring chest tube, and adjusted odds ratios for these complications associated with various biopsy characteristics, calculated using multivariable population-averaged generalized estimating equations. Although hemorrhage was rare, complicating 1.0% (95% CI 0.9-1.2%) of biopsies, 17.8% (95% CI 11.8-23.8%) of patients with hemorrhage required a blood transfusion. By contrast, the risk of any pneumothorax was 15.0% (95% CI 14.0-16.0%), and 6.6% (95% CI 6.0-7.2%) of all biopsies resulted in a pneumothorax requiring chest tube. Compared to patients without complications, those who experienced hemorrhage or pneumothorax requiring chest tube had longer lengths of stay (p<0.001) and were more likely to develop respiratory failure requiring mechanical ventilation (p=0.02). Patients aged 60-69 years (as opposed to younger or older patients), smokers, and those with chronic obstructive pulmonary disease had higher risk of complications. Estimated risks may be inaccurate if coding of complications is incomplete. The databases analyzed contain little clinical detail (e.g., nodule characteristics, biopsy pathology) and cannot determine whether biopsies produced useful information. While hemorrhage is an infrequent complication of transthoracic needle lung biopsy, pneumothorax is common and often necessitates chest tube placement. These population-based data should help patients and doctors make a more informed choice on whether to biopsy a pulmonary nodule. Department of Veterans Affairs and National Cancer Institute K07 CA 138772
登录
查看更多内容
影响因子：
158.5
作者：
Ost, D;Fein, AM;Feinsilver, SH
通讯作者：
Feinsilver, SH
影响因子：
3
作者：
De Coster, Carolyn;Li, Bing;Quan, Hude
通讯作者：
Quan, Hude
影响因子：
39.2
作者：
Croswell, Jennifer M.;Baker, Stuart G.;Kramer, Barnett S.
通讯作者：
Kramer, Barnett S.
DOI：
10.1111/j.1440-1673.2008.01990.x
发表时间：
2008-10-01
影响因子：
1.6
作者：
Laspas, F.;Roussakis, A.;Andreou, J.
通讯作者：
Andreou, J.
DOI：
10.1111/j.1440-1673.2006.01619.x
发表时间：
2006-10-01
期刊：
Australasian radiology
影响因子：
--
作者：
Yamagami, T;Kato, T;Nishimura, T
通讯作者：
Nishimura, T