介入医生性别对经支气管肺冷冻活检术的结果和并发症的影响。

The influence of the interventionalist's sex on the outcome and complications of transbronchial lung cryobiopsy.

机构信息

Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany.

出版信息

Respir Med. 2024 Nov;233:107772. doi: 10.1016/j.rmed.2024.107772. Epub 2024 Aug 13.

DOI:10.1016/j.rmed.2024.107772

PMID:39142597

Abstract

BACKGROUND

To date there are no data on sex aspects evaluating outcomes of interventional pneumology (IP). Our aim was to investigate sex differences in transbronchial lung cryobiopsy (TBLC) outcomes in the diagnosis of interstitial lung disease (ILD).

METHODS

All consecutive (TBLC)s performed for ILD evaluation between Nov 17 and Dec 21 at a tertiary referral center for ILDs and IP were analyzed. The indication for the procedure was determined by a multidisciplinary discussion (MDD). Final results including bronchoalveolar lavage (BAL) and histology were discussed in a 2nd MDD and outcomes and procedure related complications were assessed.

RESULTS

TBLC was performed in 406 patients (38.4 % female/67.8 years/FVC 76.8 %). Among 32 interventionalists, 16 females performed 53 % of interventions. Females had longer procedure times (29.9 vs. 26.6 min, p = 0.046), used fluoroscopy more often (76.7 vs. 50.3 %, p < 0.001) and obtained more samples (3.6 vs. 3.2, p = 0.021) than their male counterparts. No difference was found for major bleeding or pneumothorax. MDD was able to conclude on a diagnosis in 88.4 % of interventions performed by women and in 78.5 % performed by men (p = 0.010). In a multivariate analysis, female gender (OR 1.93) and lower FVC% values (OR 0.98) were significantly associated with diagnostic yield, whereas the number of biopsies, professional experience, use of fluoroscopy or antiplatelet drugs were not relevant.

CONCLUSION

The results of this study strengthen the role of women in endoscopy and may help to motivate women to pursue a career in IP.

摘要

背景

迄今为止，尚无关于介入肺病学（IP）评估结果的性别方面的数据。我们的目的是研究经支气管肺冷冻活检（TBLC）在诊断间质性肺病（ILD）中的性别差异。

方法

分析了 2022 年 11 月 17 日至 12 月 21 日在一家ILD 和 IP 三级转诊中心进行的所有用于ILD 评估的连续（TBLC）。该程序的适应证由多学科讨论（MDD）确定。在第二次 MDD 中讨论了最终结果，包括支气管肺泡灌洗（BAL）和组织学结果，并评估了结果和与程序相关的并发症。

结果

在 406 名患者（38.4%女性/67.8 岁/FVC 76.8%）中进行了 TBLC。在 32 名介入医师中，16 名女性进行了 53%的介入操作。女性的手术时间更长（29.9 与 26.6 分钟，p=0.046），更常使用透视（76.7%与 50.3%，p<0.001），获得的样本更多（3.6 与 3.2，p=0.021）。在主要出血或气胸方面没有差异。女性进行的 88.4%的干预措施和男性进行的 78.5%的干预措施能够通过 MDD 得出诊断（p=0.010）。多变量分析显示，女性（OR 1.93）和较低的 FVC%值（OR 0.98）与诊断率显著相关，而活检次数、专业经验、透视或抗血小板药物的使用则不相关。