Abstract
BackgroundLipoprotein concentrations have been associated with the major risk of bleeding events. However, whether plasma levels of LDL-C are associated with the risk of biopsy-related endobronchial hemorrhage remain elusive. Therefore, the present study was initiated to investigate the explicit association of low-density lipoprotein cholesterol (LDL-C) with endobronchial biopsy (EBB)-induced refractory hemorrhage in patients with lung cancer.MethodsThis retrospective study included a total of 659 consecutive patients with lung cancer who had undergone EBB at a tertiary hospital between January 2014 and April 2018. Using multiple regression analysis, the association between LDL-C and the risk of EBB-induced refractory hemorrhage was assessed after adjusting for potential confounding factors.ResultsA significant proportion (13.8%, 91/659) of the patients experienced refractory hemorrhage following EBB. In multivariate regression analysis, higher plasma LDL-C concentrations were associated with increased risk of EBB-induced refractory hemorrhage in patients with lung cancer after adjusting for potential confounders (P < 0.05). Using the lowest quartile of plasma LDL-C as the reference group, the odds ratio (95% confidence interval) of Q2, Q3, and Q4 were 2.32 (1.07, 5.03), 2.37 (0.94, 5.95), and 3.65 (1.16, 11.51), respectively (P for trend < 0.05). Moreover, this association was noticeably more pronounced in male patients with lung cancer in the subgroup analysis (P < 0.05).ConclusionsPlasma LDL-C was positively correlated with the increased risk of EBB-induced refractory hemorrhage in patients with lung cancer; predominantly, the associated risk was more pronounced in male patients with lung cancer.
Highlights
Lipoprotein concentrations have been associated with the major risk of bleeding events
As refractory bleeding during bronchoscopy remains extremely challenging and there are no definitive preoperative predictors reported, the present study hypothesized that low-density lipoprotein cholesterol (LDL-C) may be associated with biopsy-related endobronchial hemorrhage and may represent a potentially modifiable risk factor prior to endobronchial biopsy (EBB)
Histological type (Fig. 1), neutrophil percentage, C-reactive protein (CRP), prothrombin time (PT), activated partial thromboplastin time (APTT), and Alanine aminotransferase (ALT) correlated with EBB-induced refractory bleeding as assessed by univariate analysis (P < 0.05, Table 1)
Summary
Lipoprotein concentrations have been associated with the major risk of bleeding events. Whether plasma levels of LDL-C are associated with the risk of biopsy-related endobronchial hemorrhage remain elusive. The present study was initiated to investigate the explicit association of low-density lipoprotein cholesterol (LDL-C) with endobronchial biopsy (EBB)-induced refractory hemorrhage in patients with lung cancer. Low-density lipoprotein cholesterol (LDL-C) represents a well-established risk factor for cardiovascular disease [7] and has been documented to be associated with high risk of intracerebral hemorrhage [8, 9]. As refractory bleeding during bronchoscopy remains extremely challenging and there are no definitive preoperative predictors reported, the present study hypothesized that LDL-C may be associated with biopsy-related endobronchial hemorrhage and may represent a potentially modifiable risk factor prior to EBB. The present study was initiated to investigate the explicit relationship between plasma LDL-C and EBBinduced refractory hemorrhage in patients with lung cancer
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