Risk factors of pneumothorax after CT-guided coaxial cutting needle lung biopsy through aerated versus nonaerated lung.
OBJECTIVE
To compare the risk factors of developing a pneumothorax after computed tomography-guided lung biopsy in cases in which aerated lung is traversed and in cases in which aerated lung is not traversed.


METHODS
The records of 381 patients from July 2005-December 2009 were retrospectively reviewed. Multivariable analysis of patient demographic characteristics, lung lesion characteristics, and biopsy procedure details was performed with respect to the development of pneumothorax.


RESULTS
Among 381 patients, 249 biopsies traversed aerated lung tissue, and 132 biopsies did not traverse aerated lung tissue. Patients in whom aerated lung tissue was traversed had a significantly higher rate of pneumothorax. When aerated lung was not traversed, lesion size (≤ 2 cm vs > 2 cm; P = .025) and pleural-lesion angle (odds ratio = 1.033/degree; P = .004) were associated with pneumothorax. When aerated lung was traversed, location (middle vs upper; P = .009) and a transfissure approach (yes vs no; P = .001) were associated with pneumothorax.


CONCLUSIONS
When aerated lung was not traversed, lesion size and pleural-lesion angle were associated with pneumothorax, and when aerated lung was traversed, location and a transfissure approach were associated with pneumothorax.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, #289 Jianguo Road, Xindian District, New Taipei City 23141, Taiwan.
Chor-Shen
CS
Lim
Department of Internal Medicine, Yi Min Hospital, Taipei, Taiwan.
Lan-Eng
LE
Tan
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
Jann-Yuan
JY
Wang
Department of Pulmonary Medicine, Taipei Medical University, Wanfang Hospital, Taipei, Taiwan.
Chih-Hsin
CH
Lee
Department of Medical Imaging, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, #289 Jianguo Road, Xindian District, New Taipei City 23141, Taiwan.
Hsu-Chao
HC
Chang
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, #289 Jianguo Road, Xindian District, New Taipei City 23141, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
Chou-Chin
CC
Lan
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, #289 Jianguo Road, Xindian District, New Taipei City 23141, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
Mei-Chen
MC
Yang
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, #289 Jianguo Road, Xindian District, New Taipei City 23141, Taiwan.
Thomas
T
Chang-Yao Tsao
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, #289 Jianguo Road, Xindian District, New Taipei City 23141, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address: drbfci@yahoo.com.tw.
Yao-Kuang
YK
Wu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects* / Q000379:methods; D016015:Logistic Models; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011030:Pneumothorax / Q000209:etiology*; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*; D055815:Young Adult