Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study
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Pere Serra Mitjà [1] ; Filipe Gonçalves dos Santos Carvalho [1] ; Ignasi Garcia Olivé [1] ; José Sanz Santos [3] ; Jesús Jiménez López [4] ; Ana Núñez Ares [4] ; Laura Tomás López [2] ; Carmen Centeno Clemente [1] ; Rachid Tazi [1] ; Eva Castellà [1] ; Jorge Abad Capa [1] ; Antoni Rosell Gratacós [1] ; Felipe Andreo Garcia [1]
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[1] Hospital Universitari Germans Trias i Pujol
Hospital Universitari Germans Trias i Pujol
Barcelona, España
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[2] Hospital Txagorritxu
Hospital Txagorritxu
Vitoria, España
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[3] Hospital Universitari Mutua de Terrassa, España
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[4] Complejo Hospitalario de Albacete, Albacete, España
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- Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 59, Nº. 2 (February), 2023, págs. 84-89
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
The aim of our study was to describe the incidence of infectious complications of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and to analyze the potential risk factors in a prospective cohort of patients.
Methods We conducted a prospective multicenter study, with all consecutive patients referred for an EBUS-TBNA with patients at risk of developing an infectious complication (considering>10 nodal samplings, known immunosuppression, bronchial colonization and cavitated or necrotic lesions) and a second group without any risk factor.
Results Three hundred seventy patients were included: 245 with risk factors and 125 without risk factors (as the control group). Overall, 15 patients (4.05%) presented an acute infectious complication: fourteen in cases (5.7%) and 1 in controls (0.8%). Of these, 4 patients presented pneumonia, 1 mediastinitis, 4 obstructive pneumonitis and 6 mild complications (respiratory tract infection that resolved with antibiotic). Also 7 (1.9%) patients had self-limited fever. One-month follow-up showed 1 mediastinitis at sixteenth day post-EBUS, which required surgical treatment, and 3 pneumonias and 3 respiratory tract infections at nineteenth day (1.9%). All patients had a good evolution and there were no deaths related with infectious complication. We observed an increased risk of complication in patients with risk factors and in patients with necrosis (p=0.018).
Conclusions The incidence of infectious complications in a subgroup of patients with risk factors was higher than in patients without risk factors. Nevertheless, it remains low, and no fatal complication occurred, which reinforces the idea that EBUS-TBNA is a safe technique for the assessment of the mediastinum. Necrotic lesions are a risk factor of post-EBUS infection, and their puncture should be avoided.
