Surgical lung biopsy for the diagnosis of interstitial lung disease in England: 1997-2008

Hutchinson, John P.; McKeever, Tricia M.; Fogarty, Andrew W.; Navaratnam, Vidya; Hubbard, Richard B.

Abstract

Introduction: International guidelines and new targeted therapies for idiopathic pulmonary fibrosis have increased the need for accurate diagnosis of interstitial lung disease, which may lead to more surgical lung biopsies. This study aims to assess the risk of this procedure in patients from the United Kingdom.

Methods: We used Hospital Episodes Statistics data from 1997-2008 to assess the frequency of surgical lung biopsy for interstitial lung disease in England. We identified cardiothoracic surgical patients using ICD-10 codes for interstitial lung disease and OPCS-4 codes for surgical lung biopsy. We excluded those with lung resections or lung cancer. We estimated in-hospital, 30-day and 90-day mortality following the procedure, and linked to cause of death using data from the Office of National Statistics.

Results: We identified 2,820 patients with interstitial lung disease undergoing surgical lung biopsy during the 12 year period. The number of biopsies increased over the time period studied. In-hospital, 30-day and 90-day mortality were 1.7%, 2.4% and 3.9% respectively. Male sex, increasing age, increasing co-morbidity and open surgery were risk factors for mortality.

Discussion: Surgical lung biopsy for interstitial lung disease has a similar mortality to lobectomy for lung cancer, and clinicians and patients should understand the likely risks involved.

Citation

Hutchinson, J. P., McKeever, T. M., Fogarty, A. W., Navaratnam, V., & Hubbard, R. B. (in press). Surgical lung biopsy for the diagnosis of interstitial lung disease in England: 1997-2008. European Respiratory Journal, 48, https://doi.org/10.1183/13993003.00378-2016

• Journal Article Type: Article
• Acceptance Date: Jul 4, 2016
• Online Publication Date: Sep 22, 2016
• Deposit Date: Jul 8, 2016
• Publicly Available Date: Sep 22, 2016
• Journal: European Respiratory Journal
• Print ISSN: 0903-1936
• Electronic ISSN: 1399-3003
• Publisher: European Respiratory Society
• Peer Reviewed: Peer Reviewed
• Volume: 48
• DOI: https://doi.org/10.1183/13993003.00378-2016
• Keywords: Idiopathic Pulmonary Fibrosis, Interstitial Lung Disease, Surgical Lung Biopsy, Mortality
• Public URL: https://nottingham-repository.worktribe.com/output/809748
• Publisher URL: http://erj.ersjournals.com/content/early/2016/09/22/13993003.00378-2016
• Additional Information: This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication.
• Contract Date: Jul 8, 2016