Predictors of pneumothorax and chest drainage after percutaneous CT-guided lung biopsy: A prospective study

Objectives We present an analysis of predictors of pneumothorax, and pneumothorax requiring chest drainage after CT-guided lung biopsy, in one of the largest Scandinavian dataset presented. Methods We prospectively registered 875 biopsy procedures from 786 patients in one institution from January 27...

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Veröffentlicht in:European radiology 2021-06, Vol.31 (6), p.4243-4252
Hauptverfasser: Ruud, Espen Asak, Stavem, Knut, Geitung, Jonn Terje, Borthne, Arne, Søyseth, Vidar, Ashraf, Haseem
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container_end_page 4252
container_issue 6
container_start_page 4243
container_title European radiology
container_volume 31
creator Ruud, Espen Asak
Stavem, Knut
Geitung, Jonn Terje
Borthne, Arne
Søyseth, Vidar
Ashraf, Haseem
description Objectives We present an analysis of predictors of pneumothorax, and pneumothorax requiring chest drainage after CT-guided lung biopsy, in one of the largest Scandinavian dataset presented. Methods We prospectively registered 875 biopsy procedures from 786 patients in one institution from January 27, 2012, to March 1, 2017, and recorded complications including pneumothorax with or without chest drainage, and multiple variables we assumed could be associated with complications. We performed multivariable logistic regression analysis to identify predictors of pneumothorax and pneumothorax requiring chest drainage. Results Of the biopsied lesions, 65% were malignant, 29% benign, and 6% inconclusive. Pneumothorax occurred in 39% of the procedures and chest drainage was performed in 10%. In multivariable analysis, significant predictors of pneumothorax were emphysema (OR 1.92), smaller lesion size (OR 0.83, per 1 cm increase in lesion size), lateral body position during procedure (OR 2.00), longer needle time (OR 1.09, per minute), repositioning of coaxial needle with new insertion through pleura (OR 3.04), insertion through interlobar fissure (OR 5.21), and shorter distance to pleura (OR 0.79, per 1 cm increase in distance). Predictors of chest drainage were emphysema (OR 4.01), lateral body position (OR 2.61), and needle insertion through interlobar fissure (OR 4.17). Conclusion Predictors of pneumothorax were emphysema, lateral body position, needle insertion through interlobar fissure, repositioning of coaxial needle with new insertion through pleura, and shorter distance to pleura. The finding of lateral body position as a predictor of pneumothorax is not earlier described. Emphysema, lateral body position, and needle insertion through interlobar fissure were also predictors of chest drainage. Key Points • Pneumothorax is a frequent complication to CT-guided lung biopsy; a smaller fraction of these complications needs chest drainage. • Predictors for pneumothorax are emphysema, smaller lesion size, lateral body position, longer needle time, repositioning of coaxial needle with new insertion through pleura, needle insertion through the interlobar fissure, and shorter distance to pleura. • Predictors for requirement for chest drainage post CT-guided lung biopsy are emphysema, lateral body position, and needle insertion through the interlobar fissure.
doi_str_mv 10.1007/s00330-020-07449-6
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Methods We prospectively registered 875 biopsy procedures from 786 patients in one institution from January 27, 2012, to March 1, 2017, and recorded complications including pneumothorax with or without chest drainage, and multiple variables we assumed could be associated with complications. We performed multivariable logistic regression analysis to identify predictors of pneumothorax and pneumothorax requiring chest drainage. Results Of the biopsied lesions, 65% were malignant, 29% benign, and 6% inconclusive. Pneumothorax occurred in 39% of the procedures and chest drainage was performed in 10%. In multivariable analysis, significant predictors of pneumothorax were emphysema (OR 1.92), smaller lesion size (OR 0.83, per 1 cm increase in lesion size), lateral body position during procedure (OR 2.00), longer needle time (OR 1.09, per minute), repositioning of coaxial needle with new insertion through pleura (OR 3.04), insertion through interlobar fissure (OR 5.21), and shorter distance to pleura (OR 0.79, per 1 cm increase in distance). Predictors of chest drainage were emphysema (OR 4.01), lateral body position (OR 2.61), and needle insertion through interlobar fissure (OR 4.17). Conclusion Predictors of pneumothorax were emphysema, lateral body position, needle insertion through interlobar fissure, repositioning of coaxial needle with new insertion through pleura, and shorter distance to pleura. The finding of lateral body position as a predictor of pneumothorax is not earlier described. Emphysema, lateral body position, and needle insertion through interlobar fissure were also predictors of chest drainage. Key Points • Pneumothorax is a frequent complication to CT-guided lung biopsy; a smaller fraction of these complications needs chest drainage. • Predictors for pneumothorax are emphysema, smaller lesion size, lateral body position, longer needle time, repositioning of coaxial needle with new insertion through pleura, needle insertion through the interlobar fissure, and shorter distance to pleura. • Predictors for requirement for chest drainage post CT-guided lung biopsy are emphysema, lateral body position, and needle insertion through the interlobar fissure.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-020-07449-6</identifier><identifier>PMID: 33354745</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Biopsy ; Body size ; Chest ; Complications ; Diagnostic Radiology ; Drainage ; Emphysema ; Humans ; Image-Guided Biopsy ; Imaging ; Insertion ; Internal Medicine ; Interventional ; Interventional Radiology ; Lesions ; Lung - diagnostic imaging ; Lungs ; Medicine ; Medicine &amp; Public Health ; Neuroradiology ; Pleura ; Pneumothorax ; Pneumothorax - diagnostic imaging ; Pneumothorax - etiology ; Prospective Studies ; Radiography, Interventional ; Radiology ; Regression analysis ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed ; Ultrasound ; Wound drainage</subject><ispartof>European radiology, 2021-06, Vol.31 (6), p.4243-4252</ispartof><rights>European Society of Radiology 2020</rights><rights>European Society of Radiology 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-47dc4005dd2ba50ae25510d90c5c942cd408986b430ca04ddc506c1ea47312b53</citedby><cites>FETCH-LOGICAL-c441t-47dc4005dd2ba50ae25510d90c5c942cd408986b430ca04ddc506c1ea47312b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-020-07449-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-020-07449-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33354745$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ruud, Espen Asak</creatorcontrib><creatorcontrib>Stavem, Knut</creatorcontrib><creatorcontrib>Geitung, Jonn Terje</creatorcontrib><creatorcontrib>Borthne, Arne</creatorcontrib><creatorcontrib>Søyseth, Vidar</creatorcontrib><creatorcontrib>Ashraf, Haseem</creatorcontrib><title>Predictors of pneumothorax and chest drainage after percutaneous CT-guided lung biopsy: A prospective study</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives We present an analysis of predictors of pneumothorax, and pneumothorax requiring chest drainage after CT-guided lung biopsy, in one of the largest Scandinavian dataset presented. Methods We prospectively registered 875 biopsy procedures from 786 patients in one institution from January 27, 2012, to March 1, 2017, and recorded complications including pneumothorax with or without chest drainage, and multiple variables we assumed could be associated with complications. We performed multivariable logistic regression analysis to identify predictors of pneumothorax and pneumothorax requiring chest drainage. Results Of the biopsied lesions, 65% were malignant, 29% benign, and 6% inconclusive. Pneumothorax occurred in 39% of the procedures and chest drainage was performed in 10%. In multivariable analysis, significant predictors of pneumothorax were emphysema (OR 1.92), smaller lesion size (OR 0.83, per 1 cm increase in lesion size), lateral body position during procedure (OR 2.00), longer needle time (OR 1.09, per minute), repositioning of coaxial needle with new insertion through pleura (OR 3.04), insertion through interlobar fissure (OR 5.21), and shorter distance to pleura (OR 0.79, per 1 cm increase in distance). Predictors of chest drainage were emphysema (OR 4.01), lateral body position (OR 2.61), and needle insertion through interlobar fissure (OR 4.17). Conclusion Predictors of pneumothorax were emphysema, lateral body position, needle insertion through interlobar fissure, repositioning of coaxial needle with new insertion through pleura, and shorter distance to pleura. The finding of lateral body position as a predictor of pneumothorax is not earlier described. Emphysema, lateral body position, and needle insertion through interlobar fissure were also predictors of chest drainage. Key Points • Pneumothorax is a frequent complication to CT-guided lung biopsy; a smaller fraction of these complications needs chest drainage. • Predictors for pneumothorax are emphysema, smaller lesion size, lateral body position, longer needle time, repositioning of coaxial needle with new insertion through pleura, needle insertion through the interlobar fissure, and shorter distance to pleura. • Predictors for requirement for chest drainage post CT-guided lung biopsy are emphysema, lateral body position, and needle insertion through the interlobar fissure.</description><subject>Biopsy</subject><subject>Body size</subject><subject>Chest</subject><subject>Complications</subject><subject>Diagnostic Radiology</subject><subject>Drainage</subject><subject>Emphysema</subject><subject>Humans</subject><subject>Image-Guided Biopsy</subject><subject>Imaging</subject><subject>Insertion</subject><subject>Internal Medicine</subject><subject>Interventional</subject><subject>Interventional Radiology</subject><subject>Lesions</subject><subject>Lung - diagnostic imaging</subject><subject>Lungs</subject><subject>Medicine</subject><subject>Medicine &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>Ruud, Espen Asak</au><au>Stavem, Knut</au><au>Geitung, Jonn Terje</au><au>Borthne, Arne</au><au>Søyseth, Vidar</au><au>Ashraf, Haseem</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of pneumothorax and chest drainage after percutaneous CT-guided lung biopsy: A prospective study</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>31</volume><issue>6</issue><spage>4243</spage><epage>4252</epage><pages>4243-4252</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives We present an analysis of predictors of pneumothorax, and pneumothorax requiring chest drainage after CT-guided lung biopsy, in one of the largest Scandinavian dataset presented. Methods We prospectively registered 875 biopsy procedures from 786 patients in one institution from January 27, 2012, to March 1, 2017, and recorded complications including pneumothorax with or without chest drainage, and multiple variables we assumed could be associated with complications. We performed multivariable logistic regression analysis to identify predictors of pneumothorax and pneumothorax requiring chest drainage. Results Of the biopsied lesions, 65% were malignant, 29% benign, and 6% inconclusive. Pneumothorax occurred in 39% of the procedures and chest drainage was performed in 10%. In multivariable analysis, significant predictors of pneumothorax were emphysema (OR 1.92), smaller lesion size (OR 0.83, per 1 cm increase in lesion size), lateral body position during procedure (OR 2.00), longer needle time (OR 1.09, per minute), repositioning of coaxial needle with new insertion through pleura (OR 3.04), insertion through interlobar fissure (OR 5.21), and shorter distance to pleura (OR 0.79, per 1 cm increase in distance). Predictors of chest drainage were emphysema (OR 4.01), lateral body position (OR 2.61), and needle insertion through interlobar fissure (OR 4.17). Conclusion Predictors of pneumothorax were emphysema, lateral body position, needle insertion through interlobar fissure, repositioning of coaxial needle with new insertion through pleura, and shorter distance to pleura. The finding of lateral body position as a predictor of pneumothorax is not earlier described. Emphysema, lateral body position, and needle insertion through interlobar fissure were also predictors of chest drainage. Key Points • Pneumothorax is a frequent complication to CT-guided lung biopsy; a smaller fraction of these complications needs chest drainage. • Predictors for pneumothorax are emphysema, smaller lesion size, lateral body position, longer needle time, repositioning of coaxial needle with new insertion through pleura, needle insertion through the interlobar fissure, and shorter distance to pleura. • Predictors for requirement for chest drainage post CT-guided lung biopsy are emphysema, lateral body position, and needle insertion through the interlobar fissure.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33354745</pmid><doi>10.1007/s00330-020-07449-6</doi><tpages>10</tpages></addata></record>
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subjects Biopsy
Body size
Chest
Complications
Diagnostic Radiology
Drainage
Emphysema
Humans
Image-Guided Biopsy
Imaging
Insertion
Internal Medicine
Interventional
Interventional Radiology
Lesions
Lung - diagnostic imaging
Lungs
Medicine
Medicine & Public Health
Neuroradiology
Pleura
Pneumothorax
Pneumothorax - diagnostic imaging
Pneumothorax - etiology
Prospective Studies
Radiography, Interventional
Radiology
Regression analysis
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Ultrasound
Wound drainage
title Predictors of pneumothorax and chest drainage after percutaneous CT-guided lung biopsy: A prospective study
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