Complications, consequences, and practice patterns of endobronchial ultrasound-guided transbronchial needle aspiration: Results of the AQuIRE Registry

George A. Eapen, Archan M. Shah, Xiudong Lei, Carlos A. Jimenez, Rodolfo C. Morice, Lonny Yarmus, Joshua Filner, Cynthia Ray, Gaetane Michaud, Sara R. Greenhill, Mona Sarkiss, Roberto Casal, David Rice, David E. Ost

Research output: Contribution to journalArticle

Abstract

Background: Few studies of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) have been large enough to identify risk factors for complications. The primary objective of this study was to quantify the incidence of and risk factors for complications in patients undergoing EBUS-TBNA. Methods: Data on prospectively enrolled patients undergoing EBUS-TBNA in the American College of Chest Physicians Quality Improvement Registry, Evaluation, and Education (AQuIRE) database were extracted and analyzed for the incidence, consequences, and predictors of complications. Results: We enrolled 1,317 patients at six hospitals. Complications occurred in 19 patients (1.44%; 95% CI, 0.87%-2.24%). Transbronchial lung biopsy (TBBx) was the only risk factor for complications, which occurred in 3.21% of patients who underwent the procedure and in 1.15% of those who did not (OR, 2.85; 95% CI, 1.07-7.59; P = .04). Pneumothorax occurred in seven patients (0.53%; 95% CI, 0.21%-1.09%). Escalations in level of care occurred in 14 patients (1.06%; 95% CI, 0.58%-1.78%); its risk factors were age.>70 years (OR, 4.06; 95% CI, 1.36-12.12; P = .012), inpatient status (OR, 4.93; 95% CI, 1.30-18.74; P = .019), and undergoing deep sedation or general anesthesia (OR, 4.68; 95% CI, 1.02-21.61; P = .048). TBBx was performed in only 12.6% of patients when rapid onsite cytologic evaluation (ROSE) was used and in 19.1% when it was not used (P = .006). Interhospital variation in TBBx use when ROSE was used was significant (P,<.001). Conclusions: TBBx was the only risk factor for complications during EBUS-TBNA procedures. ROSE significantly reduced the use of TBBx.

Original languageEnglish (US)
Pages (from-to)1044-1053
Number of pages10
JournalCHEST
Volume143
Issue number4
DOIs
StatePublished - Apr 2013

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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    Eapen, G. A., Shah, A. M., Lei, X., Jimenez, C. A., Morice, R. C., Yarmus, L., Filner, J., Ray, C., Michaud, G., Greenhill, S. R., Sarkiss, M., Casal, R., Rice, D., & Ost, D. E. (2013). Complications, consequences, and practice patterns of endobronchial ultrasound-guided transbronchial needle aspiration: Results of the AQuIRE Registry. CHEST, 143(4), 1044-1053. https://doi.org/10.1378/chest.12-0350