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Erschienen in: Lung 5/2019

31.07.2019 | LUNG CANCER

Increasing Numbers and Reported Adverse Events in Patients with Lung Cancer Undergoing Inpatient Lung Biopsies: A Population-Based Analysis

verfasst von: Mitchell S. von Itzstein, Arjun Gupta, Kristin C. Mara, Sahil Khanna, David E. Gerber

Erschienen in: Lung | Ausgabe 5/2019

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Abstract

Introduction

The use of molecular biomarkers to guide lung cancer management has led to increasing frequency and amounts of tissue required for repeat lung biopsies. While patient safety and reporting of adverse events has been increasingly emphasized in recent decades, the safety of lung biopsies in patients with lung cancer has only been studied in small cohorts. We therefore analyzed adverse events in patients with lung cancer undergoing lung biopsies in the National Hospital Discharge Survey (NHDS) database.

Methods

Data were abstracted using ICD-9 lung cancer diagnosis (162.X) and lung biopsy procedure codes (33.20, 33.24, 33.25, 33.26, 33.27, 33.28) from 2001 to 2010. Agency for Healthcare Research and Quality (AHRQ) Patient-Safety Indicators (PSI) were used to identify hospital-acquired adverse events. Weighted analyses were performed using SAS version 9.4.

Results

A total of 540,747 patients were included for analysis. The number of biopsies increased over time, from 51,221 in 2001, to 63,239 in 2010 (P < 0.001). Overall, 159,683 (30%) patients suffered ≥ 1-PSI event during their hospitalization. Incidence of PSI varied by biopsy type: bronchoscopic (26%), percutaneous (34%), surgical (39%). The proportion of patients with ≥ 1 PSI event increased from 24% in 2001 to 38% in 2010 (P < 0.001). Patients with ≥ 1 PSI had longer length of stay (mean, 11.6 vs 8.1 days; P < 0.001) and higher in-hospital mortality (adjusted odds ratio, 5.9, 95% CI 3.9–8.9; P < 0.001).

Conclusions

The frequency of lung biopsies performed and rate of documented adverse events in hospitalized lung cancer patients have increased. These findings have policy, funding, research, and practice implications.
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Literatur
1.
Zurück zum Zitat Piotrowska Z, Isozaki H, Lennerz JK, Gainor JF, Lennes IT, Zhu VW et al (2018) Landscape of acquired resistance to osimertinib in EGFR-mutant NSCLC and clinical validation of combined EGFR and RET inhibition with osimertinib and BLU-667 for acquired RET fusion. Cancer Discov 8(12):1529–1539CrossRef Piotrowska Z, Isozaki H, Lennerz JK, Gainor JF, Lennes IT, Zhu VW et al (2018) Landscape of acquired resistance to osimertinib in EGFR-mutant NSCLC and clinical validation of combined EGFR and RET inhibition with osimertinib and BLU-667 for acquired RET fusion. Cancer Discov 8(12):1529–1539CrossRef
2.
Zurück zum Zitat Sequist LV, Waltman BA, Dias-Santagata D, Digumarthy S, Turke AB, Fidias P et al (2011) Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors. Sci Transl Med 3(75):75ra26.CrossRef Sequist LV, Waltman BA, Dias-Santagata D, Digumarthy S, Turke AB, Fidias P et al (2011) Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors. Sci Transl Med 3(75):75ra26.CrossRef
3.
Zurück zum Zitat Gainor JF, Dardaei L, Yoda S, Friboulet L, Leshchiner I, Katayama R et al (2016) Molecular mechanisms of resistance to first- and second-generation ALK inhibitors in ALK-rearranged lung cancer. Cancer Discov. 6(10):1118–1133CrossRef Gainor JF, Dardaei L, Yoda S, Friboulet L, Leshchiner I, Katayama R et al (2016) Molecular mechanisms of resistance to first- and second-generation ALK inhibitors in ALK-rearranged lung cancer. Cancer Discov. 6(10):1118–1133CrossRef
4.
Zurück zum Zitat Rivard PE, Elwy AR, Loveland S, Zhao S, Tsilimingras D, Elixhauser A et al (2005) Applying patient safety indicators (PSIs) across health care systems: achieving data comparability. In: Henriksen K, Battles JB, Marks ES, Lewin DI (eds) Advances in patient safety: from research to implementation, vol. 2: concepts and methodology. Advances in Patient Safety, Rockville. Rivard PE, Elwy AR, Loveland S, Zhao S, Tsilimingras D, Elixhauser A et al (2005) Applying patient safety indicators (PSIs) across health care systems: achieving data comparability. In: Henriksen K, Battles JB, Marks ES, Lewin DI (eds) Advances in patient safety: from research to implementation, vol. 2: concepts and methodology. Advances in Patient Safety, Rockville.
5.
Zurück zum Zitat Chera BS, Mazur L, Buchanan I, Kim HJ, Rockwell J, Milowsky MI et al (2015) Improving patient safety in clinical oncology: applying lessons from normal accident theory. JAMA Oncol 1(7):958–964CrossRef Chera BS, Mazur L, Buchanan I, Kim HJ, Rockwell J, Milowsky MI et al (2015) Improving patient safety in clinical oncology: applying lessons from normal accident theory. JAMA Oncol 1(7):958–964CrossRef
6.
Zurück zum Zitat Weaver SJ, Lubomksi LH, Wilson RF, Pfoh ER, Martinez KA, Dy SM (2013) Promoting a culture of safety as a patient safety strategy: a systematic review. Ann Intern Med 158(5 Pt 2):369–374CrossRef Weaver SJ, Lubomksi LH, Wilson RF, Pfoh ER, Martinez KA, Dy SM (2013) Promoting a culture of safety as a patient safety strategy: a systematic review. Ann Intern Med 158(5 Pt 2):369–374CrossRef
8.
Zurück zum Zitat Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M (2017) Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol 27(1):138–148CrossRef Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M (2017) Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol 27(1):138–148CrossRef
9.
Zurück zum Zitat Wiener RS, Schwartz LM, Woloshin S, Welch HG (2011) Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule: an analysis of discharge records. Ann Intern Med 155(3):137–144CrossRef Wiener RS, Schwartz LM, Woloshin S, Welch HG (2011) Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule: an analysis of discharge records. Ann Intern Med 155(3):137–144CrossRef
10.
Zurück zum Zitat Izbicki G, Shitrit D, Yarmolovsky A, Bendayan D, Miller G, Fink G et al (2006) Is routine chest radiography after transbronchial biopsy necessary? A prospective study of 350 cases. Chest 129(6):1561–1564CrossRef Izbicki G, Shitrit D, Yarmolovsky A, Bendayan D, Miller G, Fink G et al (2006) Is routine chest radiography after transbronchial biopsy necessary? A prospective study of 350 cases. Chest 129(6):1561–1564CrossRef
11.
Zurück zum Zitat Asano F, Aoe M, Ohsaki Y, Okada Y, Sasada S, Sato S et al (2012) Deaths and complications associated with respiratory endoscopy: a survey by the Japan Society for Respiratory Endoscopy in 2010. Respirology 17(3):478–485CrossRef Asano F, Aoe M, Ohsaki Y, Okada Y, Sasada S, Sato S et al (2012) Deaths and complications associated with respiratory endoscopy: a survey by the Japan Society for Respiratory Endoscopy in 2010. Respirology 17(3):478–485CrossRef
12.
Zurück zum Zitat Tukey MH, Wiener RS (2012) Population-based estimates of transbronchial lung biopsy utilization and complications. Respir Med 106(11):1559–1565CrossRef Tukey MH, Wiener RS (2012) Population-based estimates of transbronchial lung biopsy utilization and complications. Respir Med 106(11):1559–1565CrossRef
14.
Zurück zum Zitat National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365(5), 395–409. National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365(5), 395–409.
15.
Zurück zum Zitat Liao BC, Bai YY, Lee JH, Lin CC, Lin SY, Lee YF et al (2018) Outcomes of research biopsies in clinical trials of EGFR mutation-positive non-small cell lung cancer patients pretreated with EGFR-tyrosine kinase inhibitors. J Formos Med Assoc 117(4):326–331CrossRef Liao BC, Bai YY, Lee JH, Lin CC, Lin SY, Lee YF et al (2018) Outcomes of research biopsies in clinical trials of EGFR mutation-positive non-small cell lung cancer patients pretreated with EGFR-tyrosine kinase inhibitors. J Formos Med Assoc 117(4):326–331CrossRef
16.
Zurück zum Zitat Yoon HJ, Lee HY, Lee KS, Choi YL, Ahn MJ, Park K et al (2012) Repeat biopsy for mutational analysis of non-small cell lung cancers resistant to previous chemotherapy: adequacy and complications. Radiology 265(3):939–948CrossRef Yoon HJ, Lee HY, Lee KS, Choi YL, Ahn MJ, Park K et al (2012) Repeat biopsy for mutational analysis of non-small cell lung cancers resistant to previous chemotherapy: adequacy and complications. Radiology 265(3):939–948CrossRef
17.
Zurück zum Zitat Bach PB, Cramer LD, Schrag D, Downey RJ, Gelfand SE, Begg CB (2001) The influence of hospital volume on survival after resection for lung cancer. N Engl J Med 345(3):181–188CrossRef Bach PB, Cramer LD, Schrag D, Downey RJ, Gelfand SE, Begg CB (2001) The influence of hospital volume on survival after resection for lung cancer. N Engl J Med 345(3):181–188CrossRef
18.
Zurück zum Zitat Onega T, Duell EJ, Shi X, Demidenko E, Goodman D (2009) Determinants of NCI Cancer Center attendance in Medicare patients with lung, breast, colorectal, or prostate cancer. J Gen Intern Med 24(2):205–210CrossRef Onega T, Duell EJ, Shi X, Demidenko E, Goodman D (2009) Determinants of NCI Cancer Center attendance in Medicare patients with lung, breast, colorectal, or prostate cancer. J Gen Intern Med 24(2):205–210CrossRef
19.
Zurück zum Zitat Tsai J, Grosse SD, Grant AM, Reyes NL, Hooper WC, Atrash HK (2012) Correlates of in-hospital deaths among hospitalizations with pulmonary embolism: findings from the 2001–2008 National Hospital Discharge Survey. PLoS ONE 7(7):e34048CrossRef Tsai J, Grosse SD, Grant AM, Reyes NL, Hooper WC, Atrash HK (2012) Correlates of in-hospital deaths among hospitalizations with pulmonary embolism: findings from the 2001–2008 National Hospital Discharge Survey. PLoS ONE 7(7):e34048CrossRef
20.
Zurück zum Zitat Wong CA, Jim MA, King J, Tom-Orme L, Henderson JA, Saraiya M et al (2011) Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999–2004. Cancer Causes Control. 22(12):1681–1689CrossRef Wong CA, Jim MA, King J, Tom-Orme L, Henderson JA, Saraiya M et al (2011) Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999–2004. Cancer Causes Control. 22(12):1681–1689CrossRef
21.
Zurück zum Zitat Memtsoudis SG, Besculides MC, Zellos L, Patil N, Rogers SO (2006) Trends in lung surgery: United States 1988 to 2002. Chest 130(5):1462–1470CrossRef Memtsoudis SG, Besculides MC, Zellos L, Patil N, Rogers SO (2006) Trends in lung surgery: United States 1988 to 2002. Chest 130(5):1462–1470CrossRef
22.
Zurück zum Zitat Gupta A, Tariq R, Frank RD, Jean GW, Beg MS, Pardi DS et al (2017) Trends in the incidence and outcomes of hospitalized cancer patients with clostridium difficile infection: a nationwide analysis. J Natl Compr Canc Netw 15(4):466–472CrossRef Gupta A, Tariq R, Frank RD, Jean GW, Beg MS, Pardi DS et al (2017) Trends in the incidence and outcomes of hospitalized cancer patients with clostridium difficile infection: a nationwide analysis. J Natl Compr Canc Netw 15(4):466–472CrossRef
23.
Zurück zum Zitat Gupta A, Das A, Tariq R, Bhulani N, Premnath N, Solanky D et al (2018) Trends in outcomes of patients with metastatic cancer undergoing intubation and mechanical ventilation: results of the national hospital discharge survey. J Natl Compr Canc Netw 16(3):286–292CrossRef Gupta A, Das A, Tariq R, Bhulani N, Premnath N, Solanky D et al (2018) Trends in outcomes of patients with metastatic cancer undergoing intubation and mechanical ventilation: results of the national hospital discharge survey. J Natl Compr Canc Netw 16(3):286–292CrossRef
25.
Zurück zum Zitat Vincent C, Aylin P, Franklin BD, Holmes A, Iskander S, Jacklin A et al (2008) Is health care getting safer? BMJ 337:a2426CrossRef Vincent C, Aylin P, Franklin BD, Holmes A, Iskander S, Jacklin A et al (2008) Is health care getting safer? BMJ 337:a2426CrossRef
26.
Zurück zum Zitat Downey JR, Hernandez-Boussard T, Banka G, Morton JM (2012) Is patient safety improving? National trends in patient safety indicators: 1998–2007. Health Serv Res 47(1 Pt 2):414–430CrossRef Downey JR, Hernandez-Boussard T, Banka G, Morton JM (2012) Is patient safety improving? National trends in patient safety indicators: 1998–2007. Health Serv Res 47(1 Pt 2):414–430CrossRef
27.
Zurück zum Zitat Levinson DR (2008) Adverse events in hospitals: an overview of key issues. DHHS Publication No. OEI-06-07-00470. Office of the Inspector General, Department of Health and Human Services, Washington, DC Levinson DR (2008) Adverse events in hospitals: an overview of key issues. DHHS Publication No. OEI-06-07-00470. Office of the Inspector General, Department of Health and Human Services, Washington, DC
28.
Zurück zum Zitat Nguyen MC, Moffatt-Bruce SD, Van Buren A, Gonsenhauser I, Eiferman DS (2018) Daily review of AHRQ patient safety indicators has important impact on value-based purchasing, reimbursement, and performance scores. Surgery 163(3):542–546CrossRef Nguyen MC, Moffatt-Bruce SD, Van Buren A, Gonsenhauser I, Eiferman DS (2018) Daily review of AHRQ patient safety indicators has important impact on value-based purchasing, reimbursement, and performance scores. Surgery 163(3):542–546CrossRef
29.
Zurück zum Zitat Weissman JS, Lopez L, Schneider EC, Epstein AM, Lipsitz S, Weingart SN (2014) The association of hospital quality ratings with adverse events. Int J Qual Health Care 26(2):129–135CrossRef Weissman JS, Lopez L, Schneider EC, Epstein AM, Lipsitz S, Weingart SN (2014) The association of hospital quality ratings with adverse events. Int J Qual Health Care 26(2):129–135CrossRef
30.
Zurück zum Zitat Sukumar S, Roghmann F, Trinh VQ, Sammon JD, Gervais MK, Tan HJ et al (2013) National trends in hospital-acquired preventable adverse events after major cancer surgery in the USA. BMJ Open 3(6):e002843CrossRef Sukumar S, Roghmann F, Trinh VQ, Sammon JD, Gervais MK, Tan HJ et al (2013) National trends in hospital-acquired preventable adverse events after major cancer surgery in the USA. BMJ Open 3(6):e002843CrossRef
31.
Zurück zum Zitat Narain W (2017) Assessing estimates of patient safety derived from coded data. J Healthc Qual. 39(4):230–242CrossRef Narain W (2017) Assessing estimates of patient safety derived from coded data. J Healthc Qual. 39(4):230–242CrossRef
32.
Zurück zum Zitat U.S. Department of Health and Human Services CfDCaPaNCI (1999–2016) United States cancer statistics: data visualizations. changes over time: lung and bronchus U.S. Cancer Statistics Data Visualizations Tool, based on November 2018 submission data. www.cdc.gov/cancer/dataviz U.S. Department of Health and Human Services CfDCaPaNCI (1999–2016) United States cancer statistics: data visualizations. changes over time: lung and bronchus U.S. Cancer Statistics Data Visualizations Tool, based on November 2018 submission data. www.​cdc.​gov/​cancer/​dataviz
Metadaten
Titel
Increasing Numbers and Reported Adverse Events in Patients with Lung Cancer Undergoing Inpatient Lung Biopsies: A Population-Based Analysis
verfasst von
Mitchell S. von Itzstein
Arjun Gupta
Kristin C. Mara
Sahil Khanna
David E. Gerber
Publikationsdatum
31.07.2019
Verlag
Springer US
Erschienen in
Lung / Ausgabe 5/2019
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-019-00255-y

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