Mitchell S von Itzstein1, Arjun Gupta1,2, Kristin C Mara3, Sahil Khanna4, David E Gerber5,6,7,8. 1. Department of Internal Medicine, UT Southwestern Medical Center, Dallas, USA. 2. Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA. 3. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. 4. Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA. 5. Department of Internal Medicine, UT Southwestern Medical Center, Dallas, USA. david.gerber@utsouthwestern.edu. 6. Department of Population & Data Sciences, UT Southwestern Medical Center, Dallas, USA. david.gerber@utsouthwestern.edu. 7. Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390-9093, USA. david.gerber@utsouthwestern.edu. 8. Division of Hematology-Oncology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Mail Code 8852, Dallas, TX, 75390-8852, USA. david.gerber@utsouthwestern.edu.
Abstract
INTRODUCTION: The use of molecular biomarkers to guide lung cancer management has led to increasing frequency and amounts of tissue required for repeat lung biopsies. While patient safety and reporting of adverse events has been increasingly emphasized in recent decades, the safety of lung biopsies in patients with lung cancer has only been studied in small cohorts. We therefore analyzed adverse events in patients with lung cancer undergoing lung biopsies in the National Hospital Discharge Survey (NHDS) database. METHODS: Data were abstracted using ICD-9 lung cancer diagnosis (162.X) and lung biopsy procedure codes (33.20, 33.24, 33.25, 33.26, 33.27, 33.28) from 2001 to 2010. Agency for Healthcare Research and Quality (AHRQ) Patient-Safety Indicators (PSI) were used to identify hospital-acquired adverse events. Weighted analyses were performed using SAS version 9.4. RESULTS: A total of 540,747 patients were included for analysis. The number of biopsies increased over time, from 51,221 in 2001, to 63,239 in 2010 (P < 0.001). Overall, 159,683 (30%) patients suffered ≥ 1-PSI event during their hospitalization. Incidence of PSI varied by biopsy type: bronchoscopic (26%), percutaneous (34%), surgical (39%). The proportion of patients with ≥ 1 PSI event increased from 24% in 2001 to 38% in 2010 (P < 0.001). Patients with ≥ 1 PSI had longer length of stay (mean, 11.6 vs 8.1 days; P < 0.001) and higher in-hospital mortality (adjusted odds ratio, 5.9, 95% CI 3.9-8.9; P < 0.001). CONCLUSIONS: The frequency of lung biopsies performed and rate of documented adverse events in hospitalized lung cancer patients have increased. These findings have policy, funding, research, and practice implications.
INTRODUCTION: The use of molecular biomarkers to guide lung cancer management has led to increasing frequency and amounts of tissue required for repeat lung biopsies. While patient safety and reporting of adverse events has been increasingly emphasized in recent decades, the safety of lung biopsies in patients with lung cancer has only been studied in small cohorts. We therefore analyzed adverse events in patients with lung cancer undergoing lung biopsies in the National Hospital Discharge Survey (NHDS) database. METHODS: Data were abstracted using ICD-9 lung cancer diagnosis (162.X) and lung biopsy procedure codes (33.20, 33.24, 33.25, 33.26, 33.27, 33.28) from 2001 to 2010. Agency for Healthcare Research and Quality (AHRQ) Patient-Safety Indicators (PSI) were used to identify hospital-acquired adverse events. Weighted analyses were performed using SAS version 9.4. RESULTS: A total of 540,747 patients were included for analysis. The number of biopsies increased over time, from 51,221 in 2001, to 63,239 in 2010 (P < 0.001). Overall, 159,683 (30%) patients suffered ≥ 1-PSI event during their hospitalization. Incidence of PSI varied by biopsy type: bronchoscopic (26%), percutaneous (34%), surgical (39%). The proportion of patients with ≥ 1 PSI event increased from 24% in 2001 to 38% in 2010 (P < 0.001). Patients with ≥ 1 PSI had longer length of stay (mean, 11.6 vs 8.1 days; P < 0.001) and higher in-hospital mortality (adjusted odds ratio, 5.9, 95% CI 3.9-8.9; P < 0.001). CONCLUSIONS: The frequency of lung biopsies performed and rate of documented adverse events in hospitalized lung cancerpatients have increased. These findings have policy, funding, research, and practice implications.
Authors: Bhishamjit S Chera; Lukasz Mazur; Ian Buchanan; Hong Jin Kim; John Rockwell; Matthew I Milowsky; Lawrence B Marks Journal: JAMA Oncol Date: 2015-10 Impact factor: 31.777
Authors: Denise R Aberle; Amanda M Adams; Christine D Berg; William C Black; Jonathan D Clapp; Richard M Fagerstrom; Ilana F Gareen; Constantine Gatsonis; Pamela M Marcus; JoRean D Sicks Journal: N Engl J Med Date: 2011-06-29 Impact factor: 91.245
Authors: Zofia Piotrowska; Hideko Isozaki; Jochen K Lennerz; Justin F Gainor; Inga T Lennes; Viola W Zhu; Nicolas Marcoux; Mandeep K Banwait; Subba R Digumarthy; Wenjia Su; Satoshi Yoda; Amanda K Riley; Varuna Nangia; Jessica J Lin; Rebecca J Nagy; Richard B Lanman; Dora Dias-Santagata; Mari Mino-Kenudson; A John Iafrate; Rebecca S Heist; Alice T Shaw; Erica K Evans; Corinne Clifford; Sai-Hong I Ou; Beni Wolf; Aaron N Hata; Lecia V Sequist Journal: Cancer Discov Date: 2018-09-26 Impact factor: 39.397
Authors: Mitchell S von Itzstein; Arjun Gupta; Kemp H Kernstine; Kristin C Mara; Sahil Khanna; David E Gerber Journal: PLoS One Date: 2020-04-09 Impact factor: 3.240
Authors: Kelley Weinfurtner; Joshua Cho; Daniel Ackerman; James X Chen; Abashai Woodard; Wuyan Li; David Ostrowski; Michael C Soulen; Mandeep Dagli; Susan Shamimi-Noori; Jeffrey Mondschein; Deepak Sudheendra; S William Stavropoulos; Shilpa Reddy; Jonas Redmond; Tamim Khaddash; Darshana Jhala; Evan S Siegelman; Emma E Furth; Stephen J Hunt; Gregory J Nadolski; David E Kaplan; Terence P F Gade Journal: Sci Rep Date: 2021-11-23 Impact factor: 4.996