Pneumothorax Common After Transthoracic Needle Biopsy

Pneumothorax after transthoracic needle biopsy often needs chest tubes and prolongs hospital stay

TUESDAY, Aug. 2 (HealthDay News) -- Transthoracic needle lung biopsy of a pulmonary nodule is rarely complicated by hemorrhage, but there is a higher risk of pneumothorax that often requires chest tube placement, according to a study published in the Aug. 2 issue of the Annals of Internal Medicine.

Renda Soylemez Wiener, M.D., M.P.H., from the Boston University School of Medicine, and colleagues analyzed population-based estimates of the risks for complications after transthoracic needle biopsy of a pulmonary nodule. Data were collected from the discharge records of 15,865 adults who had undergone transthoracic needle biopsy in 2006. The percentage of biopsies with complications including hemorrhage, any pneumothorax, or pneumothorax requiring a chest tube, and their adjusted odds ratio associated with biopsy characteristics were analyzed using multivariate, population-averaged generalized estimating equations.

The investigators found that hemorrhage was rare, present in only 1 percent of the biopsies, but blood transfusion was required in 17.8 percent of patients with hemorrhage. The risk for any pneumothorax and of pneumothorax requiring a chest tube was present in 15 and 6.6 percent of all biopsies, respectively. Patients with hemorrhage or pneumothorax requiring a chest tube had significantly longer lengths of hospital stay, and significantly higher likelihood of respiratory failure requiring mechanical ventilation compared to patients without complications. The risk of complications was higher in patients who smoked, had chronic obstructive pulmonary disease, and those ages 60 to 69 years (compared to those who were younger or older).

"Whereas hemorrhage is an infrequent complication of transthoracic needle lung biopsy, pneumothorax is common and often necessitates chest tube placement," the authors write.

Full Text (subscription or payment may be required)

Physician's Briefing