Cavitation, low density areas, and stenosis of responsible bronchus are risk factors for infectious complications after endobronchial ultrasound-guided transbronchial biopsy (EBUS-GS-TBB), according to study results published in CHEST.
Medical records from consecutive patients undergoing EBUS-GS-TBB were retrospectively reviewed. Patient characteristics such as age and comorbidities, as well as lesion size, computed tomography features of target lesion, stenosis of responsible bronchus observed by bronchoscopy, and other laboratory data were then analyzed to determine associations between the potential risk factors and infectious complications.
Of the 1045 consecutive patients who received EBUS-GS-TBB, 47 developed infectious complications. Of these 47 cases, 24 were pneumonia, 14 were intratumoral infections, 3 were lung abscesses, 3 were pleuritis, and 3 were empyema. Following multivariate analysis, cavitation, intratumoral low-density areas, and stenosis of responsible bronchus observed by bronchoscopy were significantly associated with infectious complications (P =.007, P <.001, and P <.001, respectively). Furthermore, prophylactic antibiotics failed to show significant benefit in preventing infections.
“Cavitation and [intratumoral low-density areas] inside the target lesion on CT and stenosis of responsible bronchus observed by bronchoscopy are risk factors for post-EBUS-GS-TBB infection,” the researchers wrote. “Future prospective studies or clinical trials to provide effective preventive strategies for post-TBB infection are warranted.”
Souma T, Minezawa T, Yatsuya H, et al. Risk factors of infectious complications after endobronchial ultrasound-guided transbronchial biopsy [published March 4, 2020]. CHEST. doi:10.1016/j.chest.2020.02.025