Article Text

PDF
P290 Do lung function indices correlate with risk of pneumothorax following CT-guided biopsy?
  1. P Griffiths,
  2. J Heaton,
  3. S Claxton,
  4. D Hughes
  1. Wirral University Teaching Hospital NHS Foundation Trust, Liverpool, UK

Abstract

Introduction CT-guided lung biopsy is a widely used and established technique for the diagnosis of lung lesions, and several risks are well described. The most common complication is pneumothorax, occurring in approximately 20% of cases. We aimed to characterise the risk of post-procedure pneumothorax in our patient population, and determine whether lung function indices correlate with the incidence of pneumothorax.

Methods Patients undergoing CT-guided biopsy of intraparenchymal lesions from January 2014–2015 were retrospectively identified. Patients were stratified in to those with and without post-procedure pneumothorax. Spirometry and transfer factor for carbon monoxide (TLCO) were reviewed and compared using an unpaired t test.

Results 111 procedures were performed in 111 patients (53 men 58 women; mean age 70.4 years; range 40 to 88), all done for suspected malignancy. Pneumothorax was identified in 25 patients post biopsy (21%; age range 61 to 87; mean ± SD age, 73.4 ± 6.7), 12 female (48%) and 9 patients (36%) had emphysema.

Of the 25 patients with pneumothorax, FEV1 ranged from 32 to 115% predicted (80.5% ± 23.57%) and FVC ranged from 54 to 125% (91.9% ± 19.1%). TLCO was available for 14 patients, range 34 to 99% predicted (71.5% ± 19.2%). Of the 86 patients with no pneumothorax, FEV1 ranged from 27 to 126% predicted (73.9% ± 29.9%) and FVC ranged from 38 to 139% predicted (85% ± 21.9%). TLCO was available for 50 patients (58%), range 31 to 108% predicted (63.2% ± 18.9%).

There was no significant difference in FEV1 (p = 0.199), FVC (p = 0.109), FEV1/FVC ratio (0.99) or TLCO (0.176) between the two groups.

In patients developing pneumothorax, those requiring a chest drain (6/25, 24%) showed no significant difference in FEV1 or FVC (p = 0.76 and p = 0.41 respectively) to those managed conservatively. TLCO however was significantly lower in patients requiring chest drain insertion (79% ± 16.1% vs. 52.8% ± 12.8%, p = 0.002).

Conclusion From our patient group, spirometry data and TLCO showed no correlation with the frequency of pneumothorax. In those patients developing pneumothorax, a low TLCO may predict the need for invasive management.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.