Complications of CT Guided Lung Biopsies in the over 70s: 9 Year Institutional Review

Title: Complications of CT Guided Lung Biopsies in the over 70s: 9 Year Institutional Review
Author(s): H Dolphin L Greene M Rogan M Farrell S Foley
Institution: University Hospital Waterford
Poster: Click to view poster
Category: Lung Cancer/CF/ILD/Surgery
Abstract: Lung cancer occurs frequently in older patients. Studies suggest that older patients are less likely to undergo invasive diagnostic testing compared to younger patients regardless of comorbidities. CT-guided lung biopsy is the investigation of choice for peripheral lung nodules to determine pathology and to guide management. Metanalysis suggests a complication rate of 25.3% for pneumothorax, 5.6% requiring chest drain and and 18% for pulmonary haemorrhage.

The purpose of our study was to investigate the rate of
complication post CT-guided lung biopsy in patients under and over 70 and compare data to the published literature.

Incidence of complications following CT-guided lung biopsies between 2010 and 2020 was retrospectively reviewed for all patients aged 70 and over in our institution. Via accession number on National Integrated Medical Imaging System (NIMIS), the incidence of post-biopsy pneumothorax, pneumothorax requiring intervention and perilesional haemorrhage was obtained.

465 procedures were included for analysis with a patient age range of 26-91, mean age 68.2 (±10.1). 223 were female and 242 were male. 22 cases did not proceed due to a number of factors including inability to breath hold or reduction in nodule size 443/465 procedures were included for complication analysis
Overall complication rate for pneumothorax was 59/443 (13.3%) of which 15 (3.3%) required a chest drain. Pulmonary haemorrhage was recorded for 67/443 (15.1%) cases. There was no significant difference in complication rates for those over 70 with a trend towards increased chest drain placement in the older cohort.

Compared to international data, our rate of complications post CT-guided
lung biopsy in older patients is low.