title: A national analysis of the complications, cost, and mortality of percutaneous lung ablation.
abstract: OBJECTIVE
  To perform a national analysis of the safety and cost of percutaneous image-guided lung malignancy ablation.
  
  
  METHODS
  Using the National (Nationwide) Inpatient Sample, we evaluated complications, need for further intervention, in-hospital mortality, length of hospitalization, and hospital charges for patients undergoing inpatient percutaneous image-guided lung ablation in the United States during the period 2007-2011. Additionally, an analysis of the relationship between specific patient factors, procedural complications, and mortality was performed.
  
  
  RESULTS
  The study group consisted of 3,344 patients, including 2,072 (61.9%) patients treated for primary lung carcinomas and 1,277 (38.1%) patients treated for pulmonary metastatic disease. In-hospital mortality occurred after 43 (1.3%) ablation procedures. A Charlson comorbidity index score ≥ 4 was associated with higher mortality (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.16-6.91). Pneumothorax was the most common complication (38.4%), followed by pneumonia (5.7%) and effusion (4.0%). Neither pneumothorax nor chest tube insertion was associated with higher in-hospital mortality rates (pneumothorax, OR, 1.10; 95% CI, 0.59-2.04, and chest tube insertion, OR, 1.45; 95% CI, 0.78-2.68). Surgical reintervention via thoracoscopy or thoracotomy occurred in 31 cases (0.9%). Median length of hospitalization was 1 day (interquartile range, 1-3 d), and median hospital charges were $22,320 (interquartile range, $13,705-$43,026).
  
  
  CONCLUSIONS
  Percutaneous image-guided lung ablation of primary and metastatic disease has an acceptable safety profile, and surgical reintervention is rarely required. The most frequent complications of percutaneous lung ablation were not associated with increased in-hospital mortality.
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Electronic address: welch.brian@mayo.edu.
authors: Brian T
authors: BT
authors: Welch
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: Waleed
authors: W
authors: Brinjikji
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: Grant D
authors: GD
authors: Schmit
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: Matthew R
authors: MR
authors: Callstrom
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: A Nicholas
authors: AN
authors: Kurup
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: Harry J
authors: HJ
authors: Cloft
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: David A
authors: DA
authors: Woodrum
authors: Department of Thoracic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: Francis C
authors: FC
authors: Nichols
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors: Thomas D
authors: TD
authors: Atwell
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000191:economics / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D017722:Hospital Charges; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008175:Lung Neoplasms / Q000191:economics / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000191:economics / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology