Factors associated with pneumothorax and pneumothorax requiring treatment after percutaneous lung biopsy in 443 consecutive patients.
OBJECTIVE
To describe patient- and procedure-related factors associated with post-biopsy pneumothorax and those that require intervention.


METHODS
Patient and procedure data from all lung biopsies performed at a single center between January 2000 and July 2001 were recorded prospectively. Data included patient demographics, lesion size, lesion depth from skin, needle size, number of passes, patient position during biopsy, imaging method used (computed tomography/fluoroscopy), if sedation was used, occurrence of pneumothorax and whether the pneumothorax required treatment. Patient charts were retrospectively reviewed to determine smoking history, as well as previous ipsilateral chest surgery or radiation therapy. Univariate and multivariate analysis was performed, and P <.05 was considered significant.


RESULTS
Four-hundred fifty-three biopsies were performed on 443 patients. One-hundred six patients (23.4%) had post-biopsy pneumothorax and 31 patients (6.8% overall, 29.2% of pneumothorax group) required intervention. By univariate analysis, increased patient age, smaller lesion size, increased depth from skin, supine position, and no history of surgery were significant predictors of biopsy-related pneumothorax. However, only increased patient age, supine position, no history of ipsilateral surgery, and history of smoking were associated with pneumothorax that required intervention. By multivariate analysis, increased patient age, smaller lesion size, and no history of surgery predicted pneumothorax; supine position, history of smoking, and no history of ipsilateral surgery predicted which patients with pneumothorax would require treatment.


CONCLUSIONS
Independent risk factors for pneumothorax include increased patient age, smaller lesion size, and no history of surgery. Previous surgery and prone positioning during biopsy appear to provide a "protective effect" against clinically significant post-biopsy pneumothorax.
Covey
Anne M
AM
Department of Diagnostic Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. coveya@mskcc.org
Gandhi
Ripal
R
Brody
Lynn A
LA
Getrajdman
George
G
Thaler
Howard T
HT
Brown
Karen T
KT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001707:Biopsy, Needle / Q000009:adverse effects*; D005471:Fluoroscopy; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology* / Q000628:therapy; D011187:Posture; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods