title: Risk factors of pneumothorax after endobronchial ultrasound-guided transbronchial biopsy for peripheral lung lesions.
abstract: BACKGROUND
  The risk of endobronchial ultrasound-guided transbronchial biopsy-related pneumothorax is a major concern and warrants further studies. The aim of our study was to estimate the risk of pneumothorax after this procedure and identify its risk factors.
  
  
  METHODS
  From 2007 to 2011, 399 patients who underwent endobronchial ultrasound-guided transbronchial biopsy for peripheral lung lesions were included in this study. The variables analyzed included patient factors, lesion factors and procedure factors. Multivariate logistic regression analysis was used to identify independent risk factors for pneumothorax.
  
  
  RESULTS
  The incidence of pneumothorax was 3.3% (13/399). Chest tube placement was required for 31% (4/13) of pneumothoraces. Independent risk factors for pneumothorax included pulmonary emphysema (OR, 55.09; 95% CI, 9.37-324.03; p<0.001) and probe position adjacent to the lesion (OR, 17.01; 95% CI, 2.85-101.64; p = 0.002). The number of biopsy specimens, age, sex, history of prior lung surgery and lesion size, location and character did not influence the risk of pneumothorax in our analyses.
  
  
  CONCLUSIONS
  The risk of pneumothorax after endobronchial ultrasound-guided transbronchial biopsy is low. To further reduce the risk of pneumothorax, every effort should be made to advance the endobronchial ultrasound probe into the bronchus where it is imaged within the target lesion before embarking on transbronchial biopsy.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Huang
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Ruan
authors.forename: Wei-Yu
authors.initials: WY
authors.lastname: Liao
authors.forename: Yao-Wen
authors.initials: YW
authors.lastname: Kuo
authors.forename: Chi-Ying
authors.initials: CY
authors.lastname: Lin
authors.forename: Yi-Ju
authors.initials: YJ
authors.lastname: Tsai
authors.forename: Chao-Chi
authors.initials: CC
authors.lastname: Ho
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects*; D001980:Bronchi / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography