Are older patients at increased risk of adverse events? Safety and outcome of transthoracic needle aspiration biopsy in patients 70-79 vs. ≥80 years suspected of having lung cancer

Abstract

Background: Transthoracic needle aspiration biopsy (TTNAB) is a common investigation for peripheral lung lesions. Risk of lung cancer and incidence of fragility increases with age. Little is known about complication rate or outcome of TTNAB in patients ≥80 years. Objectives To evaluate whether age ≥80 years was associated with increased complication rates and lower diagnostic yield of TTNAB. Methods: A retrospective, non-interventional study on consecutive patients ≥70 years undergoing out-patient TTNAB for suspected lung cancer. We compared two patient groups: ≥80 years vs 70-79 years. All data (age, gender, comorbidities, performance status, data on tumor, TTNAB procedure, and pathology) were acquired from electronic medical files. Results: Totally 117 patients (≥80 years: n=33; 28%) underwent 152 TTNABs with 32 adverse events (AE; pneumothorax: n=29; haemoptysis: n=3; no fatalities or intensive care admissions). Patients ≥80 years experienced more AEs after TTNAB (36% vs 20%; p The groups did not differ in tumor size/depth/location/stage, age, gender, tobacco use, emphysema presence, or image guidance technique used. Conclusions In octogenarians or older, out-patient TTNAB is an efficacious test for peripheral lung lesions but implies an increased risk of non-fatal adverse events (pneumothorax and admission).