Factors affecting the development of pneumothorax in transthoracic fine-needle aspiration biopsies

Background Pneumothorax is the most common complication and reason for hospitalization in needle biopsies of lung. Purpose To investigate the factors that determine the risk and severity of pneumothorax in needle biopsies of lung. Material and Methods Fine-needle aspiration biopsy was performed for diagnostic purposes in 505 patients under the guidance of computed tomography for lung lesions. Findings were analyzed in terms of demographic characteristics of patients' and procedure-related features. Results The mean age of the patients was 65 +/- 9.7 years and mean lesion size was 34.31 +/- 16.99 mm. Pneumothorax developed in 176 patients. The frequency and severity of pneumothorax were higher in male patients (P < 0.001 and P = 0.003). Emphysema was a risk factor for pneumothorax (P = 0.002). The rate of pneumothorax was higher in lower lobe lesions. Pleural length made a significant difference, especially for the severity of pneumothorax. The severity of pneumothorax increased as dwell time increased (P = 0.029). The need for a chest tube was significantly higher in the group with pneumothorax thickness >1 cm (P < 0.001). The requirement for multiple passes increased the risk of developing pneumothorax (P < 0.001). Procedure-related hemorrhage reduced the risk of pneumothorax and prevented the progression of pneumothorax (P < 0.001 for both). The risk of developing pneumothorax was lowest in the supine position (P = 0.001). Conclusion Patient's sex, presence of emphysema, and lesion location are unchangeable patient-dependent factors for the development of pneumothorax. However, the aim should be to plan the process correctly and complete it with a single entry and a short dwell time.