Incidence, severity and tolerability of pneumothorax following low-dose CT-guided lung biopsy in different severities of COPD

Abstract

Background: The feasibility of pneumothorax following low-dose CT-guided puncture lung biopsy in different severities of COPD has not been reported.

Methods: The data of the patients with pulmonary lesion who underwent low-dose CT-guided lung biopsy by one experienced operator in our hospital from January 1st to September 30th in 2019 were retrospectively collected. They were divided into COPD group and non-COPD group. The risk factors, incidence and severity of pneumothorax with the severity of COPD and changes in MMRC score, treatment way and discharge time after pneumothorax were assessed.

Results: Two hundred and nineteen patients were retrospectively enrolled in this study with 64 in the COPD group and 155 in the non-COPD group. The average age, MMRC score and the incidence of pneumothorax after biopsy were significantly higher in the COPD group (64.7 ± 1.27 years, 1.02 ± 0.13, 31.3%) than in the non-COPD group (58.8 ± 1.16 years, 0.35 ± 0.06, 17.4%, P < 0.05). The incidence of pneumothorax between I-II and III-IV in COPD did not reach the significant difference (P = 0.863). COPD was the only independent risk factor for pneumothorax after biopsy in a multivariable regression (P < 0.05). MMRC score was significantly increased at post-pneumothorax in the two groups (P < 0.001). There was no significant difference in diagnostic rate, severity of pneumothorax, the proportion of delayed pneumothorax, the changes in treatment way and discharge time between the two groups (P > 0.05).

Conclusion: Although the incidence of pneumothorax after low dose CT-guided lung biopsy is increased in COPD, there was no difference in the severity of pneumothorax amongst the different severities of COPD and it is well-tolerated without increasing medical burden.

Keywords: COPD; CT-guided percutaneous lung biopsy; pneumothorax; risk factor.