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.

Abstract

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.

Citation

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
• Print ISSN: 1073-449X
• Electronic ISSN: 1535-4970
• Publisher: American Thoracic Society
• Peer Reviewed: Peer Reviewed
• Volume: 193
• Issue: 10
• Pages: 1161-1167
• DOI: https://doi.org/10.1164/rccm.201508-1632OC
• Keywords: Interstitial lung disease, Mortality, Surgery
• Public URL: https://nottingham-repository.worktribe.com/output/789990
• Publisher URL: http://www.atsjournals.org/doi/10.1164/rccm.201508-1632OC
• 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 ; DOI: 10.1164/rccm.201508-1632OC; Copyright © 2016 by the American Thoracic Society ; The final publication is available at http://www.atsjournals.org/doi/10.1164/rccm.201508-1632OC