Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study

Mitjà, Pere Serra; Carvalho, Filipe Gonçalves dos Santos; Olivé, Ignasi Garcia; Santos, José Sanz; López, José Darío Sánchez; Ares, Ana Núñez; López, Laura Tomás; Clemente, Carmen Centeno; Tazi, Rachid; Castellà, Eva; Abad, Jorge; Gratacós, Antoni Rosell; García, Felipe Andreo

doi:10.1016/j.arbres.2022.10.007

Cited by 5 publications

(10 citation statements)

References 34 publications

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“…The caveat is that many registries only documented complications occurring within the first 24–48 h, potentially missing few later events. Prospective studies with longer follow‐up have suggested rates of acute infective complications may be as high as 4% in high‐risk groups, with sampling of necrotic lesions associated with highest risk 108 …”

Section: Resultsmentioning

confidence: 99%

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Proposed quality indicators and recommended standard reporting items in performance of EBUS bronchoscopy: An official World Association for Bronchology and Interventional Pulmonology Expert Panel consensus statement

et al. 2023

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Background Since their introduction, both linear and radial endobronchial ultrasound (EBUS) have become an integral component of the practice of Pulmonology and Thoracic Oncology. The quality of health care can be measured by comparing the performance of an individual or a health service with an ideal threshold or benchmark. The taskforce sought to evaluate quality indicators in EBUS bronchoscopy based on clinical relevance/importance and on the basis that observed significant variation in outcomes indicates potential for improvement in health care outcomes. Methods A comprehensive literature review informed the composition of a comprehensive list of candidate quality indicators in EBUS. A multiple‐round modified Delphi consensus process was subsequently performed with the aim of reaching consensus over a final list of quality indicators and performance targets for these indicators. Standard reporting items were developed, with a strong preference for items where evidence demonstrates a relationship with quality indicator outcomes. Results Twelve quality Indicators are proposed, with performance targets supported by evidence from the literature. Standardized reporting items for both radial and linear EBUS are recommended, with evidence supporting their utility in assessing procedural outcomes presented. Conclusion This statement is intended to provide a framework for individual proceduralists to assess the quality of EBUS they provide their patients through the identification of clinically relevant, feasible quality measures. Emphasis is placed on outcome measures, with a preference for consistent terminology to allow communication and benchmarking between centres.

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Section: Resultsmentioning

confidence: 99%

“…Prospective studies with longer follow-up have suggested rates of acute infective complications may be as high as 4% in high-risk groups, with sampling of necrotic lesions associated with highest risk. 108 We recommend a target of <1%.…”

Section: Infectionmentioning

confidence: 99%

Proposed quality indicators and recommended standard reporting items in performance of EBUS bronchoscopy: An official World Association for Bronchology and Interventional Pulmonology Expert Panel consensus statement

et al. 2023

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“…Multiple needles passed by an experienced operator and rapid on-site cytologic evaluation are suggested to increase the diagnostic yield of EBUS-TBNA samples and provide samples that are adequate for genetic analysis ( 5 ). Numerous publications about mediastinoscopy described minor in 4.7% to 5.4% of patients ( 7 , 9 ), there is a much higher incidence of major complications with mediastinoscopy in comparison with EBUS-TBNA ( 9 ). According to a systematic review, EBUS-TBNA can rarely lead to serious complications such as respiratory failure, bleeding and infection ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…A study that looked at possible complications of EBUS-TBNA included infectious complications and associated risk factors, such as immunosuppressive patients and those taking immunosuppressants, chemotherapy or chronic corticosteroids, or in patients with cystic target lesion or if more than ten punctures were made for the same lesion during the procedure, or who had chronic bronchial colonization ( 9 ). All of these mentioned above are potential risk factors.…”

Section: Discussionmentioning

confidence: 99%

Mediastinitis and subcutaneous abscess complicated after EBUS-TBNA of 2R mediastinal lymph node

Ahmetoğlu,

Karadoğan,

Gündoğdu

et al. 2023

Tuberk Toraks

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Mediastinitis and subcutaneous abscess complicated after EBUS-TBNA of 2R mediastinal lymph node Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic tool used for the evaluation of mediastinal lymphadenopathy. It is a safe procedure, but complications such as bleeding and infection may occur. We report a case of a patient who developed a subcutaneous abscess abscess and mediastinitis after EBUS-TBNA. A 75-year-old male with a history of right nephrectomy due to renal cell carcinoma and lung adenocarcinoma history underwent EBUS-TBNA for the evaluation of a right upper paratracheal lymph node. Two weeks after the procedure, the patient presented to the emergency department with skin induration and erythema on the right clavicular area. A non-contrast neck and thorax CT scan was performed, which revealed an extensive subcutaneous abscess on the right clavicular area, extending to the supraclavicular region. The patient was hospitalized, and empirical intravenous antibiotics were initiated due to deep neck infection. Repeated drainage of the subcutaneous abscess was performed. Bacteriologic examination revealed Streptococcus mitis. The patient showed improvement with antibiotic treatment, and a follow-up ultrasound showed a decrease in the size of the abscess and was discharged approximately four weeks after hospitalization. Although very rare, serious infectious complications may develop after EBUS-TBNA, and our case report is an important example regarding its management process.

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“…Currently, diagnostic methods are classified as either invasive or non-invasive. Invasive procedures such as mediastinoscopic biopsy, ultrasound-guided bronchial needle aspiration or lymph node sampling, which will carry risks of postoperative complications to the patient [ 4 , 5 ]. Non-invasive measures on the other hand are commonly the next best test of choice.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of radiomic features extracted from primary lung adenocarcinoma in forecasting thoracic lymph node metastasis: a systematic review and meta-analysis

Wu,

Gao,

Lou

et al. 2024

BMC Pulm Med

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Background The application of radiomics in thoracic lymph node metastasis (LNM) of lung adenocarcinoma is increasing, but diagnostic performance of radiomics from primary tumor to predict LNM has not been systematically reviewed. Therefore, this study sought to provide a general overview regarding the methodological quality and diagnostic performance of using radiomic approaches to predict the likelihood of LNM in lung adenocarcinoma. Methods Studies were gathered from literature databases such as PubMed, Embase, the Web of Science Core Collection, and the Cochrane library. The Radiomic Quality Score (RQS) and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) were both used to assess the quality of each study. The pooled sensitivity, specificity, and area under the curve (AUC) of the best radiomics models in the training and validation cohorts were calculated. Subgroup and meta-regression analyses were also conducted. Results Seventeen studies with 159 to 1202 patients each were enrolled between the years of 2018 to 2022, of which ten studies had sufficient data for the quantitative evaluation. The percentage of RQS was between 11.1% and 44.4% and most of the studies were considered to have a low risk of bias and few applicability concerns in QUADAS-2. Pyradiomics and logistic regression analysis were the most commonly used software and methods for radiomics feature extraction and selection, respectively. In addition, the best prediction models in seventeen studies were mainly based on radiomics features combined with non-radiomics features (semantic features and/or clinical features). The pooled sensitivity, specificity, and AUC of the training cohorts were 0.84 (95% confidence interval (CI) [0.73–0.91]), 0.88 (95% CI [0.81–0.93]), and 0.93(95% CI [0.90–0.95]), respectively. For the validation cohorts, the pooled sensitivity, specificity, and AUC were 0.89 (95% CI [0.82–0.94]), 0.86 (95% CI [0.74–0.93]) and 0.94 (95% CI [0.91–0.96]), respectively. Conclusions Radiomic features based on the primary tumor have the potential to predict preoperative LNM of lung adenocarcinoma. However, radiomics workflow needs to be standardized to better promote the applicability of radiomics. Trial registration CRD42022375712.

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Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study

Cited by 5 publications

References 34 publications

Proposed quality indicators and recommended standard reporting items in performance of EBUS bronchoscopy: An official World Association for Bronchology and Interventional Pulmonology Expert Panel consensus statement

Proposed quality indicators and recommended standard reporting items in performance of EBUS bronchoscopy: An official World Association for Bronchology and Interventional Pulmonology Expert Panel consensus statement

Mediastinitis and subcutaneous abscess complicated after EBUS-TBNA of 2R mediastinal lymph node

Predictive value of radiomic features extracted from primary lung adenocarcinoma in forecasting thoracic lymph node metastasis: a systematic review and meta-analysis

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