Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study
Background and objective: Limited data exist regarding the adverse events of advanced diagnostic bronchoscopy, with most of the available information derived from retrospective datasets that primarily focus on early complications. Methods: We conducted a 15-month prospective cohort study among conse...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/18/4531 |
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| author | Daniele Magnini Giovanni Sotgiu Giuseppe Bello Mariangela Puci Vanina Livi Antonio Maria Dell’Anna Paolo De Santis Ruben Dell’Ariccia Marta Viscuso Maria Chiara Flore Alessandra Bisanti Daniela Paioli Antonio Gullì Fausto Leoncini Massimo Antonelli Rocco Trisolini |
| author_facet | Daniele Magnini Giovanni Sotgiu Giuseppe Bello Mariangela Puci Vanina Livi Antonio Maria Dell’Anna Paolo De Santis Ruben Dell’Ariccia Marta Viscuso Maria Chiara Flore Alessandra Bisanti Daniela Paioli Antonio Gullì Fausto Leoncini Massimo Antonelli Rocco Trisolini |
| author_sort | Daniele Magnini |
| collection | DOAJ |
| description | Background and objective: Limited data exist regarding the adverse events of advanced diagnostic bronchoscopy, with most of the available information derived from retrospective datasets that primarily focus on early complications. Methods: We conducted a 15-month prospective cohort study among consecutive patients undergoing endosonography and/or guided bronchoscopy under general anesthesia. We evaluated the 30-day incidence of severe complications, any complication, unplanned hospital encounters, and deaths. Additionally, we analyzed the time of onset (immediate, within 1 h of the procedure; early, 1 h–24 h; late, 24 h–30 days) and identified risk factors associated with these events. Results: Thirty-day data were available for 697 out of 701 (99.4%) enrolled patients, with 85.6% having suspected malignancy and multiple comorbidities (median Charlson Comorbidity Index (IQR): 4 (2–5)). Severe complications occurred in only 17 (2.4%) patients, but among them, 10 (58.8%) had unplanned hospital encounters and 2 (11.7%) died within 30 days. A significant proportion of procedure-related severe complications (8/17, 47.1%); unplanned hospital encounters (8/11, 72.7%); and the two deaths occurred days or weeks after the procedure. Low-dose attenuation in the biopsy site on computed tomography was independently associated with any complication (OR: 1.87; 95% CI 1.13–3.09); unplanned hospital encounters (OR: 2.17; 95% CI 1.10–4.30); and mortality (OR: 4.19; 95% CI 1.74–10.11). Conclusions: Severe complications arising from endosonography and guided bronchoscopy, although uncommon, have significant clinical consequences. A substantial proportion of adverse events occur days after the procedure, potentially going unnoticed and exerting a negative clinical impact if a proactive surveillance program is not implemented. |
| first_indexed | 2024-03-10T22:57:40Z |
| format | Article |
| id | doaj.art-cea2d38b303b4adeb1e15d3139b22ca3 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T22:57:40Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-cea2d38b303b4adeb1e15d3139b22ca32023-11-19T09:55:06ZengMDPI AGCancers2072-66942023-09-011518453110.3390/cancers15184531Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective StudyDaniele Magnini0Giovanni Sotgiu1Giuseppe Bello2Mariangela Puci3Vanina Livi4Antonio Maria Dell’Anna5Paolo De Santis6Ruben Dell’Ariccia7Marta Viscuso8Maria Chiara Flore9Alessandra Bisanti10Daniela Paioli11Antonio Gullì12Fausto Leoncini13Massimo Antonelli14Rocco Trisolini15Interventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyClinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyDepartment of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyClinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyInterventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyPulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyPulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyInterventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyInterventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyInterventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyInterventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyBackground and objective: Limited data exist regarding the adverse events of advanced diagnostic bronchoscopy, with most of the available information derived from retrospective datasets that primarily focus on early complications. Methods: We conducted a 15-month prospective cohort study among consecutive patients undergoing endosonography and/or guided bronchoscopy under general anesthesia. We evaluated the 30-day incidence of severe complications, any complication, unplanned hospital encounters, and deaths. Additionally, we analyzed the time of onset (immediate, within 1 h of the procedure; early, 1 h–24 h; late, 24 h–30 days) and identified risk factors associated with these events. Results: Thirty-day data were available for 697 out of 701 (99.4%) enrolled patients, with 85.6% having suspected malignancy and multiple comorbidities (median Charlson Comorbidity Index (IQR): 4 (2–5)). Severe complications occurred in only 17 (2.4%) patients, but among them, 10 (58.8%) had unplanned hospital encounters and 2 (11.7%) died within 30 days. A significant proportion of procedure-related severe complications (8/17, 47.1%); unplanned hospital encounters (8/11, 72.7%); and the two deaths occurred days or weeks after the procedure. Low-dose attenuation in the biopsy site on computed tomography was independently associated with any complication (OR: 1.87; 95% CI 1.13–3.09); unplanned hospital encounters (OR: 2.17; 95% CI 1.10–4.30); and mortality (OR: 4.19; 95% CI 1.74–10.11). Conclusions: Severe complications arising from endosonography and guided bronchoscopy, although uncommon, have significant clinical consequences. A substantial proportion of adverse events occur days after the procedure, potentially going unnoticed and exerting a negative clinical impact if a proactive surveillance program is not implemented.https://www.mdpi.com/2072-6694/15/18/4531complicationsendobronchial ultrasoundguided bronchoscopylung cancerCharlson Comorbidity Indexlow-dose attenuation |
| spellingShingle | Daniele Magnini Giovanni Sotgiu Giuseppe Bello Mariangela Puci Vanina Livi Antonio Maria Dell’Anna Paolo De Santis Ruben Dell’Ariccia Marta Viscuso Maria Chiara Flore Alessandra Bisanti Daniela Paioli Antonio Gullì Fausto Leoncini Massimo Antonelli Rocco Trisolini Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study Cancers complications endobronchial ultrasound guided bronchoscopy lung cancer Charlson Comorbidity Index low-dose attenuation |
| title | Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study |
| title_full | Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study |
| title_fullStr | Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study |
| title_full_unstemmed | Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study |
| title_short | Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study |
| title_sort | thirty day complications unplanned hospital encounters and mortality after endosonography and or guided bronchoscopy a prospective study |
| topic | complications endobronchial ultrasound guided bronchoscopy lung cancer Charlson Comorbidity Index low-dose attenuation |
| url | https://www.mdpi.com/2072-6694/15/18/4531 |
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