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英国外科肺活检在间质性肺疾病诊断中的应用:1997-2008 年。

Surgical lung biopsy for the diagnosis of interstitial lung disease in England: 1997-2008.

机构信息

Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK

Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.

出版信息

Eur Respir J. 2016 Nov;48(5):1453-1461. doi: 10.1183/13993003.00378-2016. Epub 2016 Sep 22.

Abstract

International guidelines and new targeted therapies for idiopathic pulmonary fibrosis have increased the need for accurate diagnosis of interstitial lung disease (ILD), which may lead to more surgical lung biopsies. This study aimed to assess the risk of this procedure in patients from the UK.We used Hospital Episodes Statistics data from 1997 to 2008 to assess the frequency of surgical lung biopsy for ILD in England, UK. We identified cardiothoracic surgical patients using International Classification of Diseases revision 10 codes for ILD and Office of Population Censuses and Surveys Classification of Interventions and Procedures version 4 codes for surgical lung biopsy. We excluded those with lung resections or lung cancer. We estimated in-hospital, 30-day and 90-day mortality following the procedure, and linked to cause of death using data from the UK Office of National Statistics.We identified 2820 patients with ILD undergoing surgical lung biopsy during the 12-year period. The number of biopsies increased over the time period studied. In-hospital, 30-day and 90-day mortality were 1.7%, 2.4% and 3.9%, respectively. Male sex, increasing age, increasing comorbidity and open surgery were risk factors for mortality.Surgical lung biopsy for ILD has a similar mortality to lobectomy for lung cancer, and clinicians and patients should understand the likely risks involved.

摘要

国际间特发性肺纤维化的指导方针和新的靶向治疗方法增加了对间质性肺疾病(ILD)准确诊断的需求,这可能导致更多的外科肺活检。本研究旨在评估英国患者接受此程序的风险。

我们使用 1997 年至 2008 年的医院发病统计数据,评估英国英格兰外科肺活检ILD 的频率。我们使用国际疾病分类修订版 10 代码ILD 和人口普查和调查分类干预和程序第 4 版代码外科肺活检来识别心胸外科患者。我们排除了那些有肺切除术或肺癌的患者。我们根据英国国家统计局的数据,在手术后估计住院、30 天和 90 天的死亡率,并根据死因进行关联。

我们在 12 年的时间里确定了 2820 名接受外科肺活检的ILD 患者。活检数量随着研究时间的推移而增加。住院、30 天和 90 天的死亡率分别为 1.7%、2.4%和 3.9%。男性、年龄增长、合并症增多和开放性手术是死亡的危险因素。

外科肺活检ILD 的死亡率与肺癌肺叶切除术相似,临床医生和患者应了解可能涉及的风险。

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