03:54 PM Abstract No. 409 Impact of a pleural tract sealant system on pneumothorax rates after lung biopsy at an academic institution

Abstract

To compare the safety and effectiveness of CT-guided percutaneous pericardial drainage (PPD) with surgical pericardial drainage (SPD). Materials: Using a retrospective design including a chart review, 257 patients with symptomatic pericardial effusions were identified including 142 that were treated with a PPD and 115 with SPD. Primary outcomes of interest were short-term complications and recurrence (defined as occurring in 30 days' post-procedure). Examples of complications included pneumothorax, myocardial stick, arrhythmia, DVT, CVA, etc. Recurrence was evaluated based on the presence of pericardial effusion on post-procedural imaging necessitating repeat drainage. Additional variables analyzed as surrogates of effectiveness included but were not limited to days of hospitalization, duration of drainage catheter, and change in mean arterial pressure post intervention. Tests for differences in distributions between intervention groups were performed using Wilcoxon rank sum test. Tests for differences in explanatory variables between intervention groups were performed using chi-square tests. A result was considered significant if p < 0.002 using a Bonferroni correction for multiple tests. Results: Overall, 9% of the patients experienced short-term complications and 16% had a recurrence. A statistically significant association was observed between whether or not a patient experienced short-term complication and the intervention that the patient received (p < 0.001). Among patients who experienced short-term complications, the proportion of patients who underwent SPD, 17%, was significantly greater than the proportion of patients who were treated with PPD, 2%. The estimated odds of having complications if the patient received an SPD was 9 times greater than if the patient received PPD (OR¼9.3, 95% CI: 2.7 to 32.2). No statistically significant difference was observed between whether or not a patient experienced a recurrence within 30 days post SPD or PPD (OR¼0.86, 95% CI: 0.44 to 1.7). Conclusions: CT-guided PPD is a safer alternative to SPD in patients with symptomatic pericardial effusion and the odds of recurrence within 30 days are not significantly different between the two groups.

Cost Analysis: Use of Hydrogel Plug Tract Sealant System for CT-Guided Lung Biopsy can Reduce Patient Recovery Time and Cost

“…Emphysema is another important risk factor known to increase pneumothorax rates. Of note, an abstract by Hoffman et al found that patients with emphysema have higher rates of pneumothorax when using BioSentry compared to no sealant[20] although the mechanism is unclear. Presence of emphysema was less common in our biopsy cohort, only occurring in 15.7% of patients.…”