Risk factors associated with pulmonary hemorrhage and hemoptysis following percutaneous CT-guided transthoracic lung core needle biopsy: a retrospective study of 1,090 cases

Abstract Background We aim to analyze the risk factors for pneumothorax associated with computed tomography (CT)-guided percutaneous core needle biopsy (PCNB) of the lung. Whether the lung function characteristics are related to pneumothorax is unclear. Methods We retrospectively evaluated 343 patients who received CT-guided pulmonary PCNBs and underwent preoperative pulmonary function testing. Demographical, lesion-related, procedure-related features and histopathological diagnosis, as well as results of pulmonary function test were analyzed as risk factors of pneumothorax Results Variables associated with higher rate of pneumothorax were location of lesion, presence of emphysema, and dwell time. The proportion of middle lobe, lingular, or lower lobe lesions in pneumothorax group (30/50, 60.0%) is higher than non-pneumothorax group (113/293, 38.6%). The incidence of emphysema in pneumothorax group was significantly higher than that in non-pneumothorax group (34.0% vs. 7.5%). Obstructive pulmonary function abnormalities, not restrictive, mixed ventilation function abnormalities and small airway dysfunction, correlated with pneumothorax. Multivariate logistic regression analysis showed lower location of lesion sampled and presence of emphysema were independent predictors of pneumothorax. Although dwell time, FEV1/FVC ratio, FEF50%, FEF75% and FEF25–75% were significantly correlated with pneumothorax on univariate analysis, these were not confirmed to be independent predictors. Conclusions Patients with obstructive pulmonary dysfunction have a higher risk of pneumothorax. Presence of emphysema was the most important predictor of pneumothorax, followed by location of lesion.

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The role of pulmonary function testing in predicting risk of pneumothorax by CT-guided percutaneous core needle biopsy of the lung

10.21203/rs.3.rs-210643/v1 ◽

2021 ◽

Author(s):

Chunhai Li ◽

Dexiang Wang ◽

Fengxia Yang ◽

Yang Song ◽

Xuejuan Yu ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Function ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Pulmonary Function Testing ◽

Pulmonary Dysfunction ◽

Ct Guided ◽

Core Needle ◽

Percutaneous Core Needle Biopsy ◽

Function Testing

Abstract Background To determine risk factors for pneumothorax associated with computed tomography (CT)-guided percutaneous core needle biopsy (PCNB) of the lung. Whether the lung function characteristics are related to pneumothorax is unclear. This study was designed to provide a risk assessment of pneumothorax based on pulmonary function analysis, which can predict the risk especially for patients with severe pulmonary dysfunction. Methods We retrospectively evaluated 343 patients who received CT-guided pulmonary PCNBs and underwent preoperative pulmonary function testing. Demographical, lesion-related, procedure-related features and histopathological diagnosis, as well as results of pulmonary function test were analyzed for risk factors of pneumothorax Results Variables associated with higher rate of pneumothorax were location of lesion, presence of emphysema and dwell time. Furthermore, there was significant difference of pulmonary function parameters between groups with or without pneumothorax as expressed by FEV1/FVC ratio, FEV1/FVC ratio (%, pred), FEF50% (% pred), FEF75% (% pred), and FEF25 − 75% (% pred). Obstructive pulmonary function abnormalities were associated with a higher incidence of pneumothorax. However, no correlation was found between the pneumothorax rate and the severity of pulmonary function abnormalities. Multivariate logistic regression analysis showed lower location of lesion sampled and presence of emphysema were independent predictors of pneumothorax. Conclusions Patients with obstructive pulmonary dysfunction have a higher risk of pneumothorax. FEV1/FVC ratio, FEF50%, FEF75% and FEF25 − 75% has the potential to identify the high-risk population of pneumothorax.

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