Abstract
A total of 235 patients were analyzed for pneumothorax rates (124 patient in 3-hour recovery group and 111 patients the 1.5-hour group). Pneumothorax rate on follow-up chest radiographs was 22% vs 13% in the 3-hour vs 1.5-hour recovery groups, and chest tube insertion rate was 3.9% vs 0%, respectively. In a 30-day follow-up available in 96% of patients, the 3- and 1.5-hour groups each had 1 patient hospitalized for delayed complications but neither required chest tube placement. Discharging patients if absent or small stable pneumothorax detected on 1.5-hour post-lung biopsy recovery chest radiograph resulted in total cost savings of $686 (P < 0.05) and recovery cost savings of $487 (P < 0.001) on average per patient.
Highlights
Pneumothorax rate on follow-up chest radiographs was 22% vs 13% in the 3-hour vs 1.5-hour recovery groups, and chest tube insertion rate was 3.9% vs 0%, respectively
Discharging patients if absent or small stable pneumothorax detected on 1.5-hour post-lung biopsy recovery chest radiograph resulted in total cost savings of $686 (P < 0.05) and recovery cost savings of $487 (P < 0.001) on average per patient
Hydrogel plug use and early discharge at 1.5 hours resulted in significant cost savings. 1.5-hour observation is safe for routine lung biopsies, while a longer observation is recommended for complicated patients or technically challenging biopsies
Summary
Demand for lung biopsy is increasing with rising lung cancer rates, higher detection rates of incidental pulmonary nodules, and greater need for tissue sampling for new molecular testing [1]. Complications of lung biopsy can be a substantial economic burden, increasing costs by 300-400% [8,9]. There is great interest in reducing pneumothorax rates and lowering potential costs related to chest tube placement, additional imaging, hospital admission and stay. Sealing the pleural puncture site after lung biopsy has shown to decrease pneumothorax rates. One of the best studied sealants is the polyethylene glycol hydrogel plug (BioSentryTM tract sealant system, AngioDynamics, Latham, NY), which works by expanding on contact with moisture and sealing the biopsy tract. This sealant system was the first device to be approved
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