Jie Zhang, Jianli An, Xiuxiu Jing, Jingpeng Wu, Xioxia Zhang, Hongzhi Lu, Ye Tian
{"title":"评估计算机断层扫描引导下肺活检术并发症的风险因素：预测气胸的定量分析。","authors":"Jie Zhang, Jianli An, Xiuxiu Jing, Jingpeng Wu, Xioxia Zhang, Hongzhi Lu, Ye Tian","doi":"10.5144/0256-4947.2024.228","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Computer tomography (CT)-guided lung biopsy carries the risk of pneumothorax. A variety of other risk factors affect the occurrence of pneumothorax.</p><p><strong>Objective: </strong>Assess the incidence and risk factors associated with pneumothorax complications in CT-guided lung biopsy, and to conduct a quantitative analysis of the variables among the significant risk factors to identify more effective indicators for predicting pneumothorax complications.</p><p><strong>Design: </strong>Retrospective logistic.</p><p><strong>Setting: </strong>Single center in China.</p><p><strong>Patients and methods: </strong>From June 2017 to May 2021, consecutive patients who underwent CT-guided lung biopsy were identified from the medical record system. Binary logistic regression analysis was used to identify potential risk factors for pneumothorax. Receiver operating characteristic (ROC) curves were constructed for continuous variables to determine cutoff values that optimized sensitivity and specificity.</p><p><strong>Main outcome measures: </strong>The incidence and risk factors of pneumothorax in CT-guided lung biopsy.</p><p><strong>Sample size: </strong>132 patients.</p><p><strong>Results: </strong>The incidence of pneumothorax was 28.9% (38/132), with 6.8% (9/132) of patients requiring chest tube insertion. Results indicated that smaller lesion size (OR 0.724; 95% CI 0.619-0.848; <i>P</i>=.0001), longer needle tract length (OR 1.320; 95% CI 1.145-1.521; <i>P</i>=.001), multiple passes through the pleura (OR 4.618; 95% CI 1.378-15.467; <i>P</i>=.013), and needle tract length/lesion diameter (L/D) ratio (OR 0.028; 95% CI 0.002-0.732; <i>P</i>=.007) were independent risk factors for pneumothorax. ROC curve analysis determined a cut-off value of 0.81 for the L/D ratio (sensitivity=89.5%, specificity=71.3%). The area under the ROC curve (AUC) values of maximum diameter, needle tract length, and L/D ratio for pneumothorax were 0.749, 0.812, and 0.850, respectively.</p><p><strong>Conclusions: </strong>The L/D ratio, multiple passes through the pleura, longer needle tract length, and smaller lesions were independent risk factors for pneumothorax. A L/D ratio of less than 0.81 may indicate a pneumothorax. It may be necessary to use the proper sealing procedure for this patient group.</p><p><strong>Limitations: </strong>Due to its retrospective nature, there may be inherent selection bias.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316944/pdf/","citationCount":"0","resultStr":"{\"title\":\"Assessing risk factors for complications in computer tomography-guided lung biopsy: quantitative analysis for predicting pneumothorax.\",\"authors\":\"Jie Zhang, Jianli An, Xiuxiu Jing, Jingpeng Wu, Xioxia Zhang, Hongzhi Lu, Ye Tian\",\"doi\":\"10.5144/0256-4947.2024.228\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Computer tomography (CT)-guided lung biopsy carries the risk of pneumothorax. A variety of other risk factors affect the occurrence of pneumothorax.</p><p><strong>Objective: </strong>Assess the incidence and risk factors associated with pneumothorax complications in CT-guided lung biopsy, and to conduct a quantitative analysis of the variables among the significant risk factors to identify more effective indicators for predicting pneumothorax complications.</p><p><strong>Design: </strong>Retrospective logistic.</p><p><strong>Setting: </strong>Single center in China.</p><p><strong>Patients and methods: </strong>From June 2017 to May 2021, consecutive patients who underwent CT-guided lung biopsy were identified from the medical record system. Binary logistic regression analysis was used to identify potential risk factors for pneumothorax. Receiver operating characteristic (ROC) curves were constructed for continuous variables to determine cutoff values that optimized sensitivity and specificity.</p><p><strong>Main outcome measures: </strong>The incidence and risk factors of pneumothorax in CT-guided lung biopsy.</p><p><strong>Sample size: </strong>132 patients.</p><p><strong>Results: </strong>The incidence of pneumothorax was 28.9% (38/132), with 6.8% (9/132) of patients requiring chest tube insertion. Results indicated that smaller lesion size (OR 0.724; 95% CI 0.619-0.848; <i>P</i>=.0001), longer needle tract length (OR 1.320; 95% CI 1.145-1.521; <i>P</i>=.001), multiple passes through the pleura (OR 4.618; 95% CI 1.378-15.467; <i>P</i>=.013), and needle tract length/lesion diameter (L/D) ratio (OR 0.028; 95% CI 0.002-0.732; <i>P</i>=.007) were independent risk factors for pneumothorax. ROC curve analysis determined a cut-off value of 0.81 for the L/D ratio (sensitivity=89.5%, specificity=71.3%). The area under the ROC curve (AUC) values of maximum diameter, needle tract length, and L/D ratio for pneumothorax were 0.749, 0.812, and 0.850, respectively.</p><p><strong>Conclusions: </strong>The L/D ratio, multiple passes through the pleura, longer needle tract length, and smaller lesions were independent risk factors for pneumothorax. A L/D ratio of less than 0.81 may indicate a pneumothorax. It may be necessary to use the proper sealing procedure for this patient group.</p><p><strong>Limitations: </strong>Due to its retrospective nature, there may be inherent selection bias.</p>\",\"PeriodicalId\":93875,\"journal\":{\"name\":\"Annals of Saudi medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316944/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Saudi medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5144/0256-4947.2024.228\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Saudi medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5144/0256-4947.2024.228","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/1 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景：计算机断层扫描（CT）引导下的肺活检存在气胸风险。气胸的发生还受到其他多种风险因素的影响：评估CT引导下肺活检中气胸并发症的发生率和相关危险因素，并对重要危险因素中的变量进行定量分析，以确定预测气胸并发症的更有效指标：设计：回顾性逻辑：中国单中心：2017年6月至2021年5月，从病历系统中找出连续接受CT引导下肺活检的患者。采用二元逻辑回归分析确定气胸的潜在风险因素。对连续变量构建了接收者操作特征曲线（ROC），以确定优化灵敏度和特异性的临界值：样本量：132 例患者：气胸发生率为 28.9%（38/132），其中 6.8%（9/132）的患者需要插入胸管。结果表明，较小的病灶大小（OR 0.724；95% CI 0.619-0.848；P=.0001）、较长的针道长度（OR 1.320；95% CI 1.145-1.521；P=.001）、多次穿过胸膜（OR 4.618；95% CI 1.378-15.467；P=.013）和针道长度/病变直径（L/D）比（OR 0.028；95% CI 0.002-0.732；P=.007）是气胸的独立危险因素。ROC 曲线分析确定 L/D 比值的临界值为 0.81（灵敏度=89.5%，特异度=71.3%）。气胸的最大直径、针道长度和长径比的 ROC 曲线下面积（AUC）值分别为 0.749、0.812 和 0.850：结论：L/D 比值、多次通过胸膜、针道长度较长和病灶较小是气胸的独立危险因素。长径比小于 0.81 可能预示着气胸。对于这类患者可能有必要使用适当的密封程序：由于其回顾性，可能存在固有的选择偏差。
Assessing risk factors for complications in computer tomography-guided lung biopsy: quantitative analysis for predicting pneumothorax.
Background: Computer tomography (CT)-guided lung biopsy carries the risk of pneumothorax. A variety of other risk factors affect the occurrence of pneumothorax.
Objective: Assess the incidence and risk factors associated with pneumothorax complications in CT-guided lung biopsy, and to conduct a quantitative analysis of the variables among the significant risk factors to identify more effective indicators for predicting pneumothorax complications.
Design: Retrospective logistic.
Setting: Single center in China.
Patients and methods: From June 2017 to May 2021, consecutive patients who underwent CT-guided lung biopsy were identified from the medical record system. Binary logistic regression analysis was used to identify potential risk factors for pneumothorax. Receiver operating characteristic (ROC) curves were constructed for continuous variables to determine cutoff values that optimized sensitivity and specificity.
Main outcome measures: The incidence and risk factors of pneumothorax in CT-guided lung biopsy.
Sample size: 132 patients.
Results: The incidence of pneumothorax was 28.9% (38/132), with 6.8% (9/132) of patients requiring chest tube insertion. Results indicated that smaller lesion size (OR 0.724; 95% CI 0.619-0.848; P=.0001), longer needle tract length (OR 1.320; 95% CI 1.145-1.521; P=.001), multiple passes through the pleura (OR 4.618; 95% CI 1.378-15.467; P=.013), and needle tract length/lesion diameter (L/D) ratio (OR 0.028; 95% CI 0.002-0.732; P=.007) were independent risk factors for pneumothorax. ROC curve analysis determined a cut-off value of 0.81 for the L/D ratio (sensitivity=89.5%, specificity=71.3%). The area under the ROC curve (AUC) values of maximum diameter, needle tract length, and L/D ratio for pneumothorax were 0.749, 0.812, and 0.850, respectively.
Conclusions: The L/D ratio, multiple passes through the pleura, longer needle tract length, and smaller lesions were independent risk factors for pneumothorax. A L/D ratio of less than 0.81 may indicate a pneumothorax. It may be necessary to use the proper sealing procedure for this patient group.
Limitations: Due to its retrospective nature, there may be inherent selection bias.
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