Papavasileiou Vasileios, Raptakis Thomas, Lavasidis Georgios, Niotis Georgios, Papavasileiou Katerina, Lampadakis Stefanos, Athanasopoulou Vasiliki, Siozos Pavlos, Vandorou Kalliopi Theoni, Nizami Garyfallia, Loukides Stelios, Voulgareli Ilektra
2nd Respiratory Medicine Department, "Attikon" University General Hospital, 12461 Athens, Greece.
Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110 Ioannina, Greece.
J Clin Med. 2025 Apr 21;14(8):2848. doi: 10.3390/jcm14082848.
Flexible bronchoscopy and its new methods have revolutionized the era of the diagnosis, staging, and restaging of lung cancer. A rare late complication is post-bronchoscopy respiratory infection, but it is critical due to treatment delays, treatment cancellation, and death. The aim of this study is to identify risk factors for respiratory tract infection after bronchoscopy in patients with lung cancer. A retrospective single-center observational study of 182 hospitalized patients was conducted at U.G.H. "ATTIKON" who underwent bronchoscopy for diagnosis/staging/restaging of lung cancer from January 2022 to April 2023. Patients were divided into two groups based on whether or not they developed post-bronchoscopy respiratory infection. Analyzing the data between the groups, several potential risk factors for infection were identified, including recent hospitalization for COVID-19 within the last month (OR: 6.16; = 0.01), history of COPD (OR: 8; = 0.03), presence of emphysema on CT scan (OR: 8; = 0.03), endobronchial lesions causing ≥ 50% bronchial obstruction with inability to advance the bronchoscope (OR: 9.6; < 0.01), increased white blood cell count (≥8.5 K/μL) before bronchoscopy (OR: 8; = 0.03), and advanced stage IV non-small-cell lung cancer (OR: 9.67; = 0.02). Comparing our results with previous studies on risk factors for respiratory infections after bronchoscopy, we found that recent hospitalization for SARS-CoV-2 infection was a unique finding in our study. With the increasing incidence of lung cancer worldwide and the critical role of bronchoscopy in diagnosis/staging/restaging, large multicenter studies are needed to identify these risk factors and develop strategies for early detection, treatment, and prevention.
可弯曲支气管镜检查及其新方法彻底改变了肺癌诊断、分期及再分期的时代。一种罕见的晚期并发症是支气管镜检查后呼吸道感染，但由于治疗延误、治疗取消及死亡，它至关重要。本研究的目的是确定肺癌患者支气管镜检查后呼吸道感染的危险因素。对雅典阿提卡大学综合医院（U.G.H. “ATTIKON”）182例住院患者进行了一项回顾性单中心观察性研究，这些患者在2022年1月至2023年4月期间因肺癌诊断/分期/再分期接受了支气管镜检查。根据患者是否发生支气管镜检查后呼吸道感染将其分为两组。通过分析两组间的数据，确定了几个潜在的感染危险因素，包括过去一个月内因新冠病毒病近期住院（比值比：6.16；P = 0.01）、慢性阻塞性肺疾病史（比值比：8；P = 0.03）、CT扫描显示存在肺气肿（比值比：8；P = 0.03）、导致≥50%支气管阻塞且无法推进支气管镜的支气管内病变（比值比：9.6；P < 0.01）、支气管镜检查前白细胞计数升高（≥8.5 K/μL）（比值比：8；P = 0.03）以及晚期IV期非小细胞肺癌（比值比：9.67；P = 0.02）。将我们的结果与先前关于支气管镜检查后呼吸道感染危险因素的研究进行比较，我们发现因严重急性呼吸综合征冠状病毒2感染近期住院是我们研究中的一个独特发现。随着全球肺癌发病率的上升以及支气管镜检查在诊断/分期/再分期中的关键作用，需要开展大型多中心研究来确定这些危险因素，并制定早期检测、治疗和预防策略。
