Transbronchial Lung Cryobiopsy is Safe and Effective for Diagnosing Acutely Ill Hospitalized Patients with New Diffuse Parenchymal Lung Disease
Introduction Transbronchial lung cryobiopsy (TBLC) is an accepted alternative to surgical lung biopsy (SLB) for diagnosing diffuse parenchymal lung disease (DPLD) that is less invasive and results in comparable diagnostic yields. Performing lung biopsies on hospitalized patients, however, has increa...
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description | Introduction
Transbronchial lung cryobiopsy (TBLC) is an accepted alternative to surgical lung biopsy (SLB) for diagnosing diffuse parenchymal lung disease (DPLD) that is less invasive and results in comparable diagnostic yields. Performing lung biopsies on hospitalized patients, however, has increased risk due to the patient’s underlying disease severity. Data evaluating the safety and efficacy of TBLC in hospitalized patients are limited. We present a comparison of TBLC for hospitalized and outpatients and provide the safety and diagnostic yields in these populations.
Methods
Demographic data, pulmonary function values, chest imaging pattern, procedural information, and diagnosis were recorded from enrolled patients. Complications from the procedure were the primary outcomes and diagnostic yield was the secondary outcome.
Results
77 patients (
n
= 22 hospitalized vs
n
= 55 outpatient) underwent TBLC during the study period. Comparing adverse events between hospitalized and outpatients revealed no statistically significant differences in pneumothorax (9%,
n
= 2 vs 5%,
n
= 3), tube thoracostomy placement (5%,
n
= 1 vs 2%,
n
= 1), grade 2 bleeding (9%,
n
= 2 vs 0%,
n
= 0), escalation in level of care (5%,
n
= 1 vs 0%,
n
= 0), 30-day mortality (9%,
n
= 2 vs 2%,
n
= 1), and 60-day mortality (9%,
n
= 2 vs 4%,
n
= 2) (
p
> 0.05 for all). No deaths were attributed to the procedure. 95% of cases received a multidisciplinary conference diagnosis (hospitalized 100%,
n
= 22 vs outpatients 93%,
n
= 51,
p
= 0.32).
Conclusion
Our experience supports that TBLC may be a safe and effective modality for acutely ill-hospitalized patients with DPLD. Further efforts to enhance procedural safety and to determine the impact of an expedited tissue diagnosis on patient outcomes are needed. |
doi_str_mv | 10.1007/s00408-022-00513-6 |
format | Article |
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Transbronchial lung cryobiopsy (TBLC) is an accepted alternative to surgical lung biopsy (SLB) for diagnosing diffuse parenchymal lung disease (DPLD) that is less invasive and results in comparable diagnostic yields. Performing lung biopsies on hospitalized patients, however, has increased risk due to the patient’s underlying disease severity. Data evaluating the safety and efficacy of TBLC in hospitalized patients are limited. We present a comparison of TBLC for hospitalized and outpatients and provide the safety and diagnostic yields in these populations.
Methods
Demographic data, pulmonary function values, chest imaging pattern, procedural information, and diagnosis were recorded from enrolled patients. Complications from the procedure were the primary outcomes and diagnostic yield was the secondary outcome.
Results
77 patients (
n
= 22 hospitalized vs
n
= 55 outpatient) underwent TBLC during the study period. Comparing adverse events between hospitalized and outpatients revealed no statistically significant differences in pneumothorax (9%,
n
= 2 vs 5%,
n
= 3), tube thoracostomy placement (5%,
n
= 1 vs 2%,
n
= 1), grade 2 bleeding (9%,
n
= 2 vs 0%,
n
= 0), escalation in level of care (5%,
n
= 1 vs 0%,
n
= 0), 30-day mortality (9%,
n
= 2 vs 2%,
n
= 1), and 60-day mortality (9%,
n
= 2 vs 4%,
n
= 2) (
p
> 0.05 for all). No deaths were attributed to the procedure. 95% of cases received a multidisciplinary conference diagnosis (hospitalized 100%,
n
= 22 vs outpatients 93%,
n
= 51,
p
= 0.32).
Conclusion
Our experience supports that TBLC may be a safe and effective modality for acutely ill-hospitalized patients with DPLD. Further efforts to enhance procedural safety and to determine the impact of an expedited tissue diagnosis on patient outcomes are needed.</description><identifier>ISSN: 0341-2040</identifier><identifier>EISSN: 1432-1750</identifier><identifier>DOI: 10.1007/s00408-022-00513-6</identifier><identifier>PMID: 35103841</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Biopsy ; Biopsy - adverse effects ; Biopsy - methods ; Bronchoscopy - adverse effects ; Bronchoscopy - methods ; Comparative analysis ; Complications ; Diagnosis ; Diagnostic systems ; Health aspects ; Hospital patients ; Hospitalization ; Humans ; Interventional Pulmonology ; Lung - diagnostic imaging ; Lung - pathology ; Lung diseases ; Lung Diseases, Interstitial - etiology ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Mortality ; Patients ; Pneumology/Respiratory System ; Pneumothorax ; Pneumothorax - etiology ; Pulmonary functions ; Respiratory function ; Safety ; Statistical analysis</subject><ispartof>Lung, 2022-04, Vol.200 (2), p.153-159</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>COPYRIGHT 2022 Springer</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c610t-9cf096b0349e5b03912c162e64834e86734132378c0b9f6d7aa11b1620e84e9b3</citedby><cites>FETCH-LOGICAL-c610t-9cf096b0349e5b03912c162e64834e86734132378c0b9f6d7aa11b1620e84e9b3</cites><orcidid>0000-0002-1136-8287</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/s00408-022-00513-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00408-022-00513-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35103841$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Castellani, Carson</creatorcontrib><creatorcontrib>Castellani, Henry</creatorcontrib><creatorcontrib>Benn, Bryan S.</creatorcontrib><title>Transbronchial Lung Cryobiopsy is Safe and Effective for Diagnosing Acutely Ill Hospitalized Patients with New Diffuse Parenchymal Lung Disease</title><title>Lung</title><addtitle>Lung</addtitle><addtitle>Lung</addtitle><description>Introduction
Transbronchial lung cryobiopsy (TBLC) is an accepted alternative to surgical lung biopsy (SLB) for diagnosing diffuse parenchymal lung disease (DPLD) that is less invasive and results in comparable diagnostic yields. Performing lung biopsies on hospitalized patients, however, has increased risk due to the patient’s underlying disease severity. Data evaluating the safety and efficacy of TBLC in hospitalized patients are limited. We present a comparison of TBLC for hospitalized and outpatients and provide the safety and diagnostic yields in these populations.
Methods
Demographic data, pulmonary function values, chest imaging pattern, procedural information, and diagnosis were recorded from enrolled patients. Complications from the procedure were the primary outcomes and diagnostic yield was the secondary outcome.
Results
77 patients (
n
= 22 hospitalized vs
n
= 55 outpatient) underwent TBLC during the study period. Comparing adverse events between hospitalized and outpatients revealed no statistically significant differences in pneumothorax (9%,
n
= 2 vs 5%,
n
= 3), tube thoracostomy placement (5%,
n
= 1 vs 2%,
n
= 1), grade 2 bleeding (9%,
n
= 2 vs 0%,
n
= 0), escalation in level of care (5%,
n
= 1 vs 0%,
n
= 0), 30-day mortality (9%,
n
= 2 vs 2%,
n
= 1), and 60-day mortality (9%,
n
= 2 vs 4%,
n
= 2) (
p
> 0.05 for all). No deaths were attributed to the procedure. 95% of cases received a multidisciplinary conference diagnosis (hospitalized 100%,
n
= 22 vs outpatients 93%,
n
= 51,
p
= 0.32).
Conclusion
Our experience supports that TBLC may be a safe and effective modality for acutely ill-hospitalized patients with DPLD. Further efforts to enhance procedural safety and to determine the impact of an expedited tissue diagnosis on patient outcomes are needed.</description><subject>Biopsy</subject><subject>Biopsy - adverse effects</subject><subject>Biopsy - methods</subject><subject>Bronchoscopy - adverse effects</subject><subject>Bronchoscopy - methods</subject><subject>Comparative analysis</subject><subject>Complications</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Health aspects</subject><subject>Hospital patients</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Interventional Pulmonology</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - pathology</subject><subject>Lung diseases</subject><subject>Lung Diseases, Interstitial - etiology</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Patients</subject><subject>Pneumology/Respiratory System</subject><subject>Pneumothorax</subject><subject>Pneumothorax - etiology</subject><subject>Pulmonary functions</subject><subject>Respiratory function</subject><subject>Safety</subject><subject>Statistical analysis</subject><issn>0341-2040</issn><issn>1432-1750</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl2L1DAUhoso7rj6B7yQgCDedE2aNm1vhGF2dRcGFVyvQ5o56WTJJGPS7jL-Cf-yZ5z9GhmkF4Ge533PB2-WvWb0hFFaf0iUlrTJaVHklFaM5-JJNmElL3JWV_RpNqG8ZHmB0FH2IqUrSlktWPU8O-IVo7wp2ST7fRmVT10MXi-tcmQ--p7M4iZ0NqzThthEvisDRPkFOTMG9GCvgZgQyalVvQ_JIj_V4wBuQy6cI-chre2gnP0FC_JNDRb8kMiNHZbkC9ygypgxAVYiYMvN6q7nqU2gErzMnhnlEry6fY-zH5_OLmfn-fzr54vZdJ5rweiQt9rQVnS4YAsVPi0rNBMFiLLhJTSixs15wetG0641YlErxViHBIWmhLbjx9nHne967Faw0DhlVE6uo12puJFBWblf8XYp-3Atm2Z7aoYG728NYvg5QhrkyiYNzikPYUyyEEUpqooXDaJv_0Gvwhg9rodUhW6iqvkD1SsH0noTsK_emsppTXH0tm1rpPIDVA8ecMjgwVj8vcefHODxW8DK6oOCd48ES1BuWKbgxsEGn_bBYgfqGFKKYO6Px6jc5lPu8ikxn_JvPqVA0ZvHZ7-X3AUSAb4DEpZ8D_HhVv-x_QOdCO7P</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Castellani, Carson</creator><creator>Castellani, Henry</creator><creator>Benn, Bryan S.</creator><general>Springer US</general><general>Springer</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>7QL</scope><scope>7T7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1136-8287</orcidid></search><sort><creationdate>20220401</creationdate><title>Transbronchial Lung Cryobiopsy is Safe and Effective for Diagnosing Acutely Ill Hospitalized Patients with New Diffuse Parenchymal Lung Disease</title><author>Castellani, Carson ; Castellani, Henry ; Benn, Bryan S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c610t-9cf096b0349e5b03912c162e64834e86734132378c0b9f6d7aa11b1620e84e9b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biopsy</topic><topic>Biopsy - adverse effects</topic><topic>Biopsy - methods</topic><topic>Bronchoscopy - adverse effects</topic><topic>Bronchoscopy - methods</topic><topic>Comparative analysis</topic><topic>Complications</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Health aspects</topic><topic>Hospital patients</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Interventional Pulmonology</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - pathology</topic><topic>Lung diseases</topic><topic>Lung Diseases, Interstitial - etiology</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Patients</topic><topic>Pneumology/Respiratory System</topic><topic>Pneumothorax</topic><topic>Pneumothorax - etiology</topic><topic>Pulmonary functions</topic><topic>Respiratory function</topic><topic>Safety</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Castellani, Carson</creatorcontrib><creatorcontrib>Castellani, Henry</creatorcontrib><creatorcontrib>Benn, Bryan S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Lung</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Castellani, Carson</au><au>Castellani, Henry</au><au>Benn, Bryan S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transbronchial Lung Cryobiopsy is Safe and Effective for Diagnosing Acutely Ill Hospitalized Patients with New Diffuse Parenchymal Lung Disease</atitle><jtitle>Lung</jtitle><stitle>Lung</stitle><addtitle>Lung</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>200</volume><issue>2</issue><spage>153</spage><epage>159</epage><pages>153-159</pages><issn>0341-2040</issn><eissn>1432-1750</eissn><abstract>Introduction
Transbronchial lung cryobiopsy (TBLC) is an accepted alternative to surgical lung biopsy (SLB) for diagnosing diffuse parenchymal lung disease (DPLD) that is less invasive and results in comparable diagnostic yields. Performing lung biopsies on hospitalized patients, however, has increased risk due to the patient’s underlying disease severity. Data evaluating the safety and efficacy of TBLC in hospitalized patients are limited. We present a comparison of TBLC for hospitalized and outpatients and provide the safety and diagnostic yields in these populations.
Methods
Demographic data, pulmonary function values, chest imaging pattern, procedural information, and diagnosis were recorded from enrolled patients. Complications from the procedure were the primary outcomes and diagnostic yield was the secondary outcome.
Results
77 patients (
n
= 22 hospitalized vs
n
= 55 outpatient) underwent TBLC during the study period. Comparing adverse events between hospitalized and outpatients revealed no statistically significant differences in pneumothorax (9%,
n
= 2 vs 5%,
n
= 3), tube thoracostomy placement (5%,
n
= 1 vs 2%,
n
= 1), grade 2 bleeding (9%,
n
= 2 vs 0%,
n
= 0), escalation in level of care (5%,
n
= 1 vs 0%,
n
= 0), 30-day mortality (9%,
n
= 2 vs 2%,
n
= 1), and 60-day mortality (9%,
n
= 2 vs 4%,
n
= 2) (
p
> 0.05 for all). No deaths were attributed to the procedure. 95% of cases received a multidisciplinary conference diagnosis (hospitalized 100%,
n
= 22 vs outpatients 93%,
n
= 51,
p
= 0.32).
Conclusion
Our experience supports that TBLC may be a safe and effective modality for acutely ill-hospitalized patients with DPLD. Further efforts to enhance procedural safety and to determine the impact of an expedited tissue diagnosis on patient outcomes are needed.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35103841</pmid><doi>10.1007/s00408-022-00513-6</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1136-8287</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Biopsy Biopsy - adverse effects Biopsy - methods Bronchoscopy - adverse effects Bronchoscopy - methods Comparative analysis Complications Diagnosis Diagnostic systems Health aspects Hospital patients Hospitalization Humans Interventional Pulmonology Lung - diagnostic imaging Lung - pathology Lung diseases Lung Diseases, Interstitial - etiology Medical diagnosis Medicine Medicine & Public Health Mortality Patients Pneumology/Respiratory System Pneumothorax Pneumothorax - etiology Pulmonary functions Respiratory function Safety Statistical analysis |
title | Transbronchial Lung Cryobiopsy is Safe and Effective for Diagnosing Acutely Ill Hospitalized Patients with New Diffuse Parenchymal Lung Disease |
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