Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy

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 a...

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Veröffentlicht in:European radiology 2018-03, Vol.28 (3), p.1328-1337
Hauptverfasser: Lim, Woo Hyeon, Park, Chang Min, Yoon, Soon Ho, Lim, Hyun-Ju, Hwang, Eui Jin, Lee, Jong Hyuk, Goo, Jin Mo
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container_end_page 1337
container_issue 3
container_start_page 1328
container_title European radiology
container_volume 28
creator Lim, Woo Hyeon
Park, Chang Min
Yoon, Soon Ho
Lim, Hyun-Ju
Hwang, Eui Jin
Lee, Jong Hyuk
Goo, Jin Mo
description 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.
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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.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-017-5058-7</identifier><identifier>PMID: 28971242</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Aged ; Biopsy ; Biopsy, Needle - adverse effects ; Biopsy, Needle - methods ; Catheters ; Chest ; Clinical significance ; Cone-Beam Computed Tomography - methods ; Diagnostic Radiology ; Emphysema ; Female ; Humans ; Image-Guided Biopsy - adverse effects ; Image-Guided Biopsy - methods ; Imaging ; Incidence ; Insertion ; Internal Medicine ; Interventional Radiology ; Lesions ; Lungs ; Male ; Medical instruments ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Neuroradiology ; Parameter estimation ; Placement ; Pneumothorax ; Pneumothorax - epidemiology ; Pneumothorax - etiology ; Radiology ; Regression analysis ; Republic of Korea - epidemiology ; Risk analysis ; Risk Factors ; Time dependent analysis ; Time Factors ; Transportation services ; Ultrasound ; Wound drainage</subject><ispartof>European radiology, 2018-03, Vol.28 (3), p.1328-1337</ispartof><rights>European Society of Radiology 2017</rights><rights>European Radiology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-7c5d49a601b8768ff89408c3644345be7c6703dd007e14de240e823d6982b6383</citedby><cites>FETCH-LOGICAL-c438t-7c5d49a601b8768ff89408c3644345be7c6703dd007e14de240e823d6982b6383</cites><orcidid>0000-0003-1884-3738</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-017-5058-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-017-5058-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28971242$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lim, Woo Hyeon</creatorcontrib><creatorcontrib>Park, Chang Min</creatorcontrib><creatorcontrib>Yoon, Soon Ho</creatorcontrib><creatorcontrib>Lim, Hyun-Ju</creatorcontrib><creatorcontrib>Hwang, Eui Jin</creatorcontrib><creatorcontrib>Lee, Jong Hyuk</creatorcontrib><creatorcontrib>Goo, Jin Mo</creatorcontrib><title>Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>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.</description><subject>Age</subject><subject>Aged</subject><subject>Biopsy</subject><subject>Biopsy, Needle - adverse effects</subject><subject>Biopsy, Needle - methods</subject><subject>Catheters</subject><subject>Chest</subject><subject>Clinical significance</subject><subject>Cone-Beam Computed Tomography - methods</subject><subject>Diagnostic Radiology</subject><subject>Emphysema</subject><subject>Female</subject><subject>Humans</subject><subject>Image-Guided Biopsy - adverse effects</subject><subject>Image-Guided Biopsy - methods</subject><subject>Imaging</subject><subject>Incidence</subject><subject>Insertion</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Lesions</subject><subject>Lungs</subject><subject>Male</subject><subject>Medical instruments</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Neuroradiology</subject><subject>Parameter estimation</subject><subject>Placement</subject><subject>Pneumothorax</subject><subject>Pneumothorax - epidemiology</subject><subject>Pneumothorax - etiology</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Republic of Korea - epidemiology</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Time dependent analysis</subject><subject>Time Factors</subject><subject>Transportation services</subject><subject>Ultrasound</subject><subject>Wound drainage</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kc2L1TAUxYMoznP0D3AjATcurN58tEmXMvgFA27GdUiT22fGNqlJC_PwnzePjgqCq4Sb3zk3nEPIcwZvGIB6WwCEgAaYalpodaMekAOTgjcMtHxIDtCLOux7eUGelHILAD2T6jG54LpXjEt-ID9vwoyNxwWjx7hSG-10KqHQNNIQXahDh69pDuU7Ha1bUy6V8dRNIQZnJ1rCMYaxXit3Fi0Rtzmt31K2d9SOK2a6YHbbaiOmrdBpi0c6hLSU01PyaLRTwWf35yX5-uH9zdWn5vrLx89X764bJ4VeG-VaL3vbARu06vQ46l6CdqKTUsh2QOU6BcL7mggy6ZFLQM2F73rNh05ocUle7b5LTj82LKuZQ3E4TfuXDOtlJ0VN8oy-_Ae9TVuumRTDATiIljFWKbZTLqdSMo5myWG2-WQYmHMzZm_G1GbMuRmjqubFvfM2zOj_KH5XUQG-A6U-xSPmv6v_7_oLtkmZVA</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Lim, Woo Hyeon</creator><creator>Park, Chang Min</creator><creator>Yoon, Soon Ho</creator><creator>Lim, Hyun-Ju</creator><creator>Hwang, Eui Jin</creator><creator>Lee, Jong Hyuk</creator><creator>Goo, Jin Mo</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1884-3738</orcidid></search><sort><creationdate>20180301</creationdate><title>Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy</title><author>Lim, Woo Hyeon ; Park, Chang Min ; Yoon, Soon Ho ; Lim, Hyun-Ju ; Hwang, Eui Jin ; Lee, Jong Hyuk ; Goo, Jin Mo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-7c5d49a601b8768ff89408c3644345be7c6703dd007e14de240e823d6982b6383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Aged</topic><topic>Biopsy</topic><topic>Biopsy, Needle - adverse effects</topic><topic>Biopsy, Needle - methods</topic><topic>Catheters</topic><topic>Chest</topic><topic>Clinical significance</topic><topic>Cone-Beam Computed Tomography - methods</topic><topic>Diagnostic Radiology</topic><topic>Emphysema</topic><topic>Female</topic><topic>Humans</topic><topic>Image-Guided Biopsy - adverse effects</topic><topic>Image-Guided Biopsy - methods</topic><topic>Imaging</topic><topic>Incidence</topic><topic>Insertion</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Lesions</topic><topic>Lungs</topic><topic>Male</topic><topic>Medical instruments</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Middle Aged</topic><topic>Neuroradiology</topic><topic>Parameter estimation</topic><topic>Placement</topic><topic>Pneumothorax</topic><topic>Pneumothorax - epidemiology</topic><topic>Pneumothorax - etiology</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Republic of Korea - epidemiology</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Time dependent analysis</topic><topic>Time Factors</topic><topic>Transportation services</topic><topic>Ultrasound</topic><topic>Wound drainage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lim, Woo Hyeon</creatorcontrib><creatorcontrib>Park, Chang Min</creatorcontrib><creatorcontrib>Yoon, Soon Ho</creatorcontrib><creatorcontrib>Lim, Hyun-Ju</creatorcontrib><creatorcontrib>Hwang, Eui Jin</creatorcontrib><creatorcontrib>Lee, Jong Hyuk</creatorcontrib><creatorcontrib>Goo, Jin Mo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing &amp; 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lim, Woo Hyeon</au><au>Park, Chang Min</au><au>Yoon, Soon Ho</au><au>Lim, Hyun-Ju</au><au>Hwang, Eui Jin</au><au>Lee, Jong Hyuk</au><au>Goo, Jin Mo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2018-03-01</date><risdate>2018</risdate><volume>28</volume><issue>3</issue><spage>1328</spage><epage>1337</epage><pages>1328-1337</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28971242</pmid><doi>10.1007/s00330-017-5058-7</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1884-3738</orcidid></addata></record>
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subjects Age
Aged
Biopsy
Biopsy, Needle - adverse effects
Biopsy, Needle - methods
Catheters
Chest
Clinical significance
Cone-Beam Computed Tomography - methods
Diagnostic Radiology
Emphysema
Female
Humans
Image-Guided Biopsy - adverse effects
Image-Guided Biopsy - methods
Imaging
Incidence
Insertion
Internal Medicine
Interventional Radiology
Lesions
Lungs
Male
Medical instruments
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Parameter estimation
Placement
Pneumothorax
Pneumothorax - epidemiology
Pneumothorax - etiology
Radiology
Regression analysis
Republic of Korea - epidemiology
Risk analysis
Risk Factors
Time dependent analysis
Time Factors
Transportation services
Ultrasound
Wound drainage
title Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy
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