Diagnostische Bronchoskopien: Auch Spätkomplikationen sind bedeutsam

Lars Hagmeyer
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Abstract

Background and objective: Limited data exist regarding the adverse events of advanced diagnostic bronchoscopy, with most of the available information derived from retrospective datasets that primarily focus on early complications. Methods: We conducted a 15-month prospective cohort study among consecutive patients undergoing endosonography and/or guided bronchoscopy under general anesthesia. We evaluated the 30-day incidence of severe complications, any complication, unplanned hospital encounters, and deaths. Additionally, we analyzed the time of onset (immediate, within 1 h of the procedure; early, 1 h–24 h; late, 24 h–30 days) and identified risk factors associated with these events. Results: Thirty-day data were available for 697 out of 701 (99.4%) enrolled patients, with 85.6% having suspected malignancy and multiple comorbidities (median Charlson Comorbidity Index (IQR): 4 (2–5)). Severe complications occurred in only 17 (2.4%) patients, but among them, 10 (58.8%) had unplanned hospital encounters and 2 (11.7%) died within 30 days. A significant proportion of procedure-related severe complications (8/17, 47.1%); unplanned hospital encounters (8/11, 72.7%); and the two deaths occurred days or weeks after the procedure. Low-dose attenuation in the biopsy site on computed tomography was independently associated with any complication (OR: 1.87; 95% CI 1.13–3.09); unplanned hospital encounters (OR: 2.17; 95% CI 1.10–4.30); and mortality (OR: 4.19; 95% CI 1.74–10.11).
诊断性支气管镜检查:晚期并发症也很严重
背景和目的:有关高级诊断性支气管镜检查不良事件的数据有限,大部分可用信息来自主要关注早期并发症的回顾性数据集。方法: 我们进行了一项为期 15 个月的前瞻性支气管镜检查:我们对在全身麻醉下接受内窥镜和/或引导下支气管镜检查的连续患者进行了为期 15 个月的前瞻性队列研究。我们评估了 30 天内严重并发症、任何并发症、非计划住院和死亡的发生率。此外,我们还分析了发病时间(即刻,术后 1 小时内;早期,1 小时至 24 小时;晚期,24 小时至 30 天),并确定了与这些事件相关的风险因素。结果:701 名登记患者中有 697 名(99.4%)获得了 30 天的数据,其中 85.6% 怀疑患有恶性肿瘤和多种合并症(夏尔森合并症指数(IQR)中位数:4 (2-5))。仅有 17 例(2.4%)患者出现严重并发症,但其中 10 例(58.8%)患者在 30 天内出现计划外住院,2 例(11.7%)患者在 30 天内死亡。很大一部分与手术相关的严重并发症(8/17,47.1%)、非计划住院(8/11,72.7%)和两例死亡发生在手术后数天或数周。计算机断层扫描活检部位的低剂量衰减与任何并发症(OR:1.87;95% CI 1.13-3.09)、非计划住院(OR:2.17;95% CI 1.10-4.30)和死亡率(OR:4.19;95% CI 1.74-10.11)均有独立关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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