Department of Respiratory Medicine, Galdakao University Hospital, Spain.
Department of Respiratory Medicine, Galdakao University Hospital, Spain.
Respir Med. 2020 Apr-May;165:105934. doi: 10.1016/j.rmed.2020.105934. Epub 2020 Mar 19.
Transbronchial lung cryobiopsy (TBLC) is an emerging technique for the diagnosis of interstitial lung disease (ILD), but its risk benefit ratio has been questioned. The objectives of this research were to describe any adverse events that occur within 90 days following TBLC and to identify clinical predictors that could help to detect the population at risk.
We conducted an ambispective study including all patients with suspected ILD who underwent TBLC. Data were collected concerning the safety profile of this procedure and compared to various clinical variables.
Overall, 257 TBLCs were analysed. Complications were observed in 15.2% of patients; nonetheless, only 5.4% of all patients required hospital admission on the day of the procedure. In the 30 and 90 days following the TBLC, rates of readmission were 1.3% and 3.5% and of mortality were 0.38%, and 0.78% respectively. Two models were built to predict early admission (AUC 0.72; 95% CI 0.59-0.84) and overall admission (AUC 0.76; 95% CI 0.67-0.85).
Within 90 days after TBLC, 8.9% of patients suffered a complication serious enough to warrant hospital admission. Modified MRC dyspnoea score ≥2, FVC<50%, and a Charlson Comorbidity Index score ≥2 were factors that predicted early and overall admission.
描述经支气管肺冷冻活检（TBLC）后 90 天内发生的任何不良事件，并确定有助于检测高危人群的临床预测因素。
我们进行了一项前瞻性研究，纳入了所有接受 TBLC 检查的疑似间质性肺病患者。收集了该程序安全性特征的数据，并与各种临床变量进行了比较。
共分析了 257 例 TBLC。15.2%的患者出现并发症；然而，只有 5.4%的患者在手术当天需要住院治疗。在 TBLC 后 30 天和 90 天，再入院率分别为 1.3%和 3.5%，死亡率分别为 0.38%和 0.78%。建立了两个模型来预测早期入院（AUC 0.72；95%CI 0.59-0.84）和总入院（AUC 0.76；95%CI 0.67-0.85）。
在 TBLC 后 90 天内，8.9%的患者发生了严重到需要住院治疗的并发症。改良的 MRC 呼吸困难评分≥2、FVC<50%和 Charlson 合并症指数评分≥2 是预测早期和总入院的因素。
