Procedure volume and mortality after surgical lung biopsy in interstitial lung disease.

Surgical volume-outcome relationships are well established but have not been studied in patients with interstitial lung disease (ILD) undergoing surgical lung biopsy (SLB). Our study objective was to determine if hospital SLB volume is associated with post-operative mortality in patients with ILD.A cohort study using administrative, population-based data from Ontario, Canada was performed in adults with ILD who underwent a SLB between 2001 and 2014. The association between yearly hospital SLB volume and 30-day post-operative mortality was assessed using multilevel logistic regression modelling.3057 surgical lung biopsies for ILD were performed during the study period with a median (interquartile range) yearly hospital volume of 73 (34-143) procedures. 30-day mortality was 7.1%, 20.2% and 1.9% in overall, nonelective and elective patients, respectively. Higher yearly hospital SLB volume was associated with lower odds of 30-day post-operative mortality after adjusting for patient characteristics (OR 0.84, 95% CI 0.73-0.97; p=0.02), with the association appearing stronger for nonelective

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Déclaration de conflit d'intérêts

Conflict of interest: J.H. Fisher reports a patient donation to the University Heath Network Foundation Interstitial Lung Disease Research Fund, during the conduct of the study. Conflict of interest: S. Shapera reports a patient donation to the University Heath Network Foundation Interstitial Lung Disease Research Fund, during the conduct of the study; personal fees from AstraZeneca and Amgen, and grants and personal fees from Boehringer Ingelheim and Hoffman-La Roche, outside the submitted work. Conflict of interest: T. To reports grants from Ontario Ministry of Health and Long-term Care, Ontario Ministry of the Environment and Climate Change, CIHR (Canadian Institute for Health Research), Health Canada and CRRN (Canadian Respiratory Research Network), outside the submitted work. Conflict of interest: T.K. Marras reports a patient donation to the University Heath Network Foundation Interstitial Lung Disease Research Fund, during the conduct of the study; grants and personal fees from Insmed, and personal fees from AstraZeneca, Horizon and RedHill, outside the submitted work. Conflict of interest: A. Gershon has nothing to disclose. Conflict of interest: S. Dell has nothing to disclose.