Risk factors of clinically significant complications in transbronchial lung cryobiopsy: A prospective multi-center study

Minna Mononen, Eeva Saari, Hannele Hasala, Hannu Pekka Kettunen, Sanna Suoranta, Hanna Nurmi, Jukka Randell, Jari Laurikka, Toomas Uibu, Heikki Koskela, Riitta Kaarteenaho, Minna Purokivi

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: The use of a transbronchial lung cryobiopsy (TBLC) is increasing as a diagnostic method of interstitial lung diseases (ILD). This study aimed to evaluate risk factors associated with clinically significant complications of TBLC in ILD patients. Methods: Patients referred to Kuopio or Tampere university hospitals, in Finland, for a suspected ILD were included. The TBLC was performed in an outpatient setting for 100 patients. Patients were mechanically ventilated in general anesthesia. Fluoroscopy guidance and prophylactic bronchial balloon were used. Complications, such as bleeding, pneumothorax, infections, and mortality were recorded. Moderate or serious bleeding, pneumothorax, or death ≤90 days were defined as clinically significant complications. A multivariable model was created to assess clinically significant complications. Results: The extent of traction bronchiectasis (Odds ratio [OR] 1.30, Confidence interval [CI] 1.03–1.65, p = 0.027) and young age (OR 7.96, CI 2.32–27.3, p = 0.001) were associated with the risk of clinically significant complications whereas the use of oral corticosteroids ≤30 days before the TBLC (OR 3.65, CI 0.911–14.6, p = 0.068) did not quite reach statistical significance. A history of serious cough was associated with the risk of pneumothorax (OR 4.18, CI 1.10–16.0, p = 0.036). Procedure associated mortality ≤90 days was 1%. Conclusion: The extent of traction bronchiectasis on HRCT and young age were associated with the risk of clinically significant complications whereas oral corticosteroid use did not quite reach statistical significance. A history of serious cough was associated with the risk of clinically significant pneumothorax.

Original languageEnglish
Article number106922
JournalRespiratory Medicine
Volume200
DOIs
Publication statusPublished - Aug 2022
Publication typeA1 Journal article-refereed

Keywords

  • Complications
  • Cough
  • Idiopathic pulmonary fibrosis (IPF)
  • Interstitial lung disease (ILD)
  • Oral corticosteroids
  • Transbronchial lung cryobiopsy

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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