Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy
Abstract
Objectives
To evaluate the time-dependent incidence, risk factors and clinical significance of percutaneous lung biopsy (PLB)-related pneumothorax.
Methods
From January 2012–November 2015, 3,251 patients underwent 3,354 cone-beam CT-guided PLBs for lung lesions. Cox, logistic and linear regression analyses were performed to identify time-dependent risk factors of PLB-related pneumothorax, risk factors of drainage catheter insertion and those of prolonged catheter placement, respectively.
Results
Pneumothorax occurred in 915/3,354 PLBs (27.3 %), with 230/915 (25.1 %) occurring during follow-ups. Risk factors for earlier occurrence of PLB-related pneumothorax include emphysema (HR=1.624), smaller target (HR=0.922), deeper location (HR=1.175) and longer puncture time (HR=1.036), while haemoptysis (HR=0.503) showed a protective effect against earlier development of pneumothorax. Seventy-five cases (8.2 %) underwent chest catheter placement. Mean duration of catheter placement was 3.2±2.0 days. Emphysema (odds ratio [OR]=2.400) and longer puncture time (OR=1.053) were assessed as significant risk factors for catheter insertion, and older age (parameter estimate=1.014) was a predictive factor for prolonged catheter placement.
Conclusion
PLB-related pneumothorax occurred in 27.3 %, of which 25.1 % developed during follow-ups. Smaller target size, emphysema, deeply-located lesions were significant risk factors of PLB-related pneumothorax. Emphysema and older age were related to drainage catheter insertion and prolonged catheter placement, respectively.
Key Points
• One-fourth of percutaneous lung biopsy (PLB)-related pneumothorax occurs during follow-up.
• Smaller, deeply-located target and emphysema lead to early occurrence of pneumothorax.
• Emphysema is related to drainage catheter insertion for PLB-related pneumothorax.
• Older age may lead to prolonged catheter placement for PLB-related pneumothorax.
• Tailored management can be possible with time-dependent information of PLB-related pneumothorax.
Publisher URL: https://link.springer.com/article/10.1007/s00330-017-5058-7
DOI: 10.1007/s00330-017-5058-7
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