Endobronchial Ultrasound-Guided TBNA Outcomes in Patients Aged 65 and Above

Recent research found that complication rates from endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) tended to be lower in those aged 65 years and above than in younger individuals, although this finding was not statistically significant. Results of this research were presented at the American Thoracic Society (ATS) 2022 International Conference, held in San Francisco, California, May 13 to 18.

Study researchers sought to assess differences in outcomes of EBUS-TBNA (ie, complications, hospitalization, length of hospitalization) in patients aged less than 65 years vs those aged 65 years and older. The most common indication for EBUS-TBNA is the staging of lung cancer. EBUS-TBNA is considered a well-established, minimally invasive procedure for sampling peribronchial masses and lung lesions. Variations in room type (operating room vs endoscopy suite), size of sampling needle, anesthesia technique, number of passes for aspiration, procedure time, number of lymph nodes, and skill of the operator/cytopathologist have all been evaluated. Although complications associated with EBUS-TBNA are low, few studies have extrapolated outcomes following the procedure according to age.

In the current study, researchers conducted a retrospective, observational study of 263 patients who underwent EBUS-TBNA at Sparrow Hospital in Lansing, Michigan, between January 2018 and January 2020. Of those, 137 patients were under 65 years of age and 126 of whom were aged 65 years or older.

The primary outcome of all complications was reported in 9.5% (13 of 137) of individuals aged less than 65 years vs 4.8% (6 of 126) in those aged 65 years or older. The relative risk for EBUS-TBNA–related complications in patients aged 65 years or older was 0.5 (95% CI, 0.2 to 1.3; P =.23). The procedure time was 48.9±18.3 minutes in individuals less than 65 years of age vs 55.8±22.1 minutes in those aged 65 years or older — a difference that was statistically significant (P =.003).

The researchers concluded that the findings from the current study regarding the protective effect of being aged 65 years and the longer procedure time for individuals in this age group might be explained by possible selection bias toward the performance of less risky procedures in individuals of a more advanced age.

Reference  

Sharma A, Anwar F, Kemnic T, Prasad RM, Wang E, Abramovitz AM. Endobronchial ultrasound-guided transbronchial needle aspiration healthcare outcomes compared to age. Presented at: American Thoracic Society (ATS) 2022 International Conference; May 13-18, 2022; San Francisco, CA. Abstract P683.