The yield of immediate post lung biopsy CT in predicting iatrogenic pneumothorax.
Aged
Aged, 80 and over
Biopsy, Needle
/ adverse effects
Female
Humans
Iatrogenic Disease
/ epidemiology
Israel
/ epidemiology
Logistic Models
Lung Neoplasms
/ pathology
Male
Middle Aged
Multivariate Analysis
Pneumothorax
/ diagnostic imaging
Predictive Value of Tests
Risk Factors
Tomography, X-Ray Computed
Biopsy
Complications
Computed tomography
Lung cancer
Pneumothorax
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
15 Apr 2020
15 Apr 2020
Historique:
received:
10
10
2019
accepted:
31
03
2020
entrez:
16
4
2020
pubmed:
16
4
2020
medline:
26
1
2021
Statut:
epublish
Résumé
The most prevalent complication of percutaneous lung biopsy is pneumothorax (PNX). A routine immediate post-procedure CT scan (ICT) to spot PNX is done in many centers. However, the diagnostic yield of this practice has not been studied broadly. We sought to evaluate whether an ICT could replace the routine follow-up chest X-ray (CXR) in detecting procedure related PNX. We examined case-records of 453 patients who underwent lung biopsy at our medical center. We analyzed findings from CXR performed 2-h after biopsy and from CT images at the site of biopsy acquired immediately after the procedure (ICT). Multivariate analysis was used to identify the risk factors for PNX, and we examined the concordance between ICT and CXR-2-h post-procedure. A total of 87 patients (19%) were diagnosed with PNX on CXR-2-h post-procedure. ICT detected 80.5% of diagnosed PNX (p < 0.01). However, ICT demonstrated a negative predictive value of only 94%, meaning 17 patients (6%) with a negative ICT did eventually develop PNX seen on CXR. Furthermore, bleeding surrounding the puncture area spotted on ICT negatively predicted the development of PNX (OR = 0.4 95% CI; 0.2-0.7). We conclude that a CT scan performed immediately after percutaneous lung biopsy cannot replace the routine follow-up CXR in predicting iatrogenic PNX. Bleeding in the needle's tract may lower the risk for procedure-related PNX.
Sections du résumé
BACKGROUND
BACKGROUND
The most prevalent complication of percutaneous lung biopsy is pneumothorax (PNX). A routine immediate post-procedure CT scan (ICT) to spot PNX is done in many centers. However, the diagnostic yield of this practice has not been studied broadly. We sought to evaluate whether an ICT could replace the routine follow-up chest X-ray (CXR) in detecting procedure related PNX.
METHODS
METHODS
We examined case-records of 453 patients who underwent lung biopsy at our medical center. We analyzed findings from CXR performed 2-h after biopsy and from CT images at the site of biopsy acquired immediately after the procedure (ICT). Multivariate analysis was used to identify the risk factors for PNX, and we examined the concordance between ICT and CXR-2-h post-procedure.
RESULTS
RESULTS
A total of 87 patients (19%) were diagnosed with PNX on CXR-2-h post-procedure. ICT detected 80.5% of diagnosed PNX (p < 0.01). However, ICT demonstrated a negative predictive value of only 94%, meaning 17 patients (6%) with a negative ICT did eventually develop PNX seen on CXR. Furthermore, bleeding surrounding the puncture area spotted on ICT negatively predicted the development of PNX (OR = 0.4 95% CI; 0.2-0.7).
CONCLUSIONS
CONCLUSIONS
We conclude that a CT scan performed immediately after percutaneous lung biopsy cannot replace the routine follow-up CXR in predicting iatrogenic PNX. Bleeding in the needle's tract may lower the risk for procedure-related PNX.
Identifiants
pubmed: 32293380
doi: 10.1186/s12890-020-1128-8
pii: 10.1186/s12890-020-1128-8
pmc: PMC7158108
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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