BMC pulmonary medicine · 2026
Predictive factors for prolonged hospitalization related to pneumothorax after CT-guided transthoracic needle biopsy.
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Ko Ui Won, Heo Mihyeon, Park Suyoung, Hwang Jung Han, Shin Beomsu
Аннотация
BACKGROUND: Pneumothorax is consistently reported as the most prevalent complication of computed tomography-guided transthoracic needle biopsy. While most cases of pneumothorax resolve with conservative management strategies, some cases are linked to a more protracted clinical trajectory necessitating active intervention. However, few reports have described the clinical and procedural determinants of prolonged hospitalization after post-biopsy pneumothorax.
METHODS: This retrospective study analyzed 1,457 CT-guided TTNB procedures performed at a tertiary referral center between January 2021 and December 2025. The incidence of post-biopsy pneumothorax was 20.5%. Among 82 patients with prolonged hospitalization due to pneumothorax, their management strategies were categorized into two groups: (1) high-concentration oxygen therapy (n = 54) and (2) invasive interventions, including percutaneous catheter drainage (PCD) or chest tube insertion (n = 28). Logistic regression models with backward selection were used to identify predictive factors for prolonged hospitalization.
RESULTS: Among the 82 patients with prolonged hospitalization due to pneumothorax, the median age was 75 years and 75.6% were male. In multivariable analysis, a lower diffusing capacity for carbon monoxide (DLCO) was independently associated with prolonged hospitalization (adjusted odds ratio [aOR], 0.980; P = 0.004). In the high-concentration oxygen group, lower DLCO (aOR, 0.974; P = 0.007) and a trans-fissural needle route (aOR, 3.968; P = 0.028) were independently associated with prolonged hospitalization. Conversely, in the PCD/chest tube group, reduced forced expiratory volume in 1 s was independently associated with prolonged hospitalization (aOR, 0.961; P = 0.002).
CONCLUSIONS: In patients with post-biopsy pneumothorax, impaired pulmonary function may be linked to a prolonged clinical course. Incorporating these pre-procedural physiological markers may facilitate improved risk stratification and optimized hospital resource allocation.
METHODS: This retrospective study analyzed 1,457 CT-guided TTNB procedures performed at a tertiary referral center between January 2021 and December 2025. The incidence of post-biopsy pneumothorax was 20.5%. Among 82 patients with prolonged hospitalization due to pneumothorax, their management strategies were categorized into two groups: (1) high-concentration oxygen therapy (n = 54) and (2) invasive interventions, including percutaneous catheter drainage (PCD) or chest tube insertion (n = 28). Logistic regression models with backward selection were used to identify predictive factors for prolonged hospitalization.
RESULTS: Among the 82 patients with prolonged hospitalization due to pneumothorax, the median age was 75 years and 75.6% were male. In multivariable analysis, a lower diffusing capacity for carbon monoxide (DLCO) was independently associated with prolonged hospitalization (adjusted odds ratio [aOR], 0.980; P = 0.004). In the high-concentration oxygen group, lower DLCO (aOR, 0.974; P = 0.007) and a trans-fissural needle route (aOR, 3.968; P = 0.028) were independently associated with prolonged hospitalization. Conversely, in the PCD/chest tube group, reduced forced expiratory volume in 1 s was independently associated with prolonged hospitalization (aOR, 0.961; P = 0.002).
CONCLUSIONS: In patients with post-biopsy pneumothorax, impaired pulmonary function may be linked to a prolonged clinical course. Incorporating these pre-procedural physiological markers may facilitate improved risk stratification and optimized hospital resource allocation.