John P. Hutchinson
In-hospital mortality following surgical lung biopsy for interstitial lung disease in the USA: 2000-2011
Hutchinson, John P.; Fogarty, Andrew W.; McKeever, Tricia M.; Hubbard, Richard B.
ANDREW FOGARTY firstname.lastname@example.org
Clinical Associate Professor & Reader in Clinical Epidemiology
TRICIA MCKEEVER email@example.com
Professor of Epidemiology and Medical Statistics
RICHARD HUBBARD firstname.lastname@example.org
Blf/Gsk Professor of Epidemiological Resp Research
Rationale: Surgical lung biopsy can help to determine a specific diagnosis in interstitial lung disease, but has associated risks. Most currently available mortality data are derived from case series and may not be generalizable to broader populations.
Objectives: We aimed to assess in-hospital mortality following surgical lung biopsy for interstitial lung disease in a national secondary care dataset from the United States.
Methods: Data were obtained from the 2000-2011 Nationwide Inpatient Sample. Cases were identified using International Classification of Diseases (ICD-9-CM) codes for interstitial lung disease and surgical lung biopsies. Lung resections and cases of lung cancer were excluded. Weighted data were used to estimate numbers of biopsies nationwide and in-hospital mortality, and multivariable logistic regression was used to adjust for sex, age, geographic region, co-morbidity, type of operation and provisional diagnosis.
Measurements and Main Results: We estimated there to be around 12,000 surgical lung biopsies performed annually for interstitial lung disease in the United States, two-thirds of which were performed electively. In-hospital mortality was 1.7% for elective procedures, but significantly higher for non-elective procedures (16.0%). Male sex, increasing age, increasing co-morbidity, open surgery and a provisional diagnosis of idiopathic pulmonary fibrosis or connective tissue disease related interstitial lung disease were risk factors for increased mortality.
Conclusions: In-hospital mortality following elective surgical lung biopsy for interstitial lung disease is just under 2%, but significantly higher for non-elective procedures. Identified risk factors for death should be taken into account when counselling patients on whether to pursue a histological diagnosis.
Hutchinson, J. P., Fogarty, A. W., McKeever, T. M., & Hubbard, R. B. (2016). In-hospital mortality following surgical lung biopsy for interstitial lung disease in the USA: 2000-2011. American Journal of Respiratory and Critical Care Medicine, 193(10), 1161-1167. https://doi.org/10.1164/rccm.201508-1632OC
|Journal Article Type||Article|
|Acceptance Date||Dec 8, 2015|
|Online Publication Date||Dec 8, 2015|
|Publication Date||May 15, 2016|
|Deposit Date||Apr 19, 2016|
|Publicly Available Date||Apr 19, 2016|
|Journal||American Journal of Respiratory and Critical Care Medicine|
|Publisher||American Thoracic Society|
|Peer Reviewed||Peer Reviewed|
|Keywords||Interstitial lung disease, Mortality, Surgery|
|Additional Information||Originally Published in:
John P Hutchinson, Andrew W Fogarty, Tricia M McKeever, and Richard B. Hubbard. In-hospital mortality following surgical lung biopsy for interstitial lung disease in the USA: 2000-2011. American Journal of Respiratory and Critical Care Medicine 2015 ; Volume 193, issue 10, pages 1161-1167
Copyright © 2016 by the American Thoracic Society
The final publication is available at http://www.atsjournals.org/doi/10.1164/rccm.201508-1632OC
Hutchinson - In-hospital mortality following surgical lung biopsy for interstitial lung disease in the USA.pdf
Hutchinson - In-hospital mortality following surgical lung biopsy for interstitial lung disease in the USA - online data supplement.pdf
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