RT Journal Article
SR Electronic
T1 Procedure volume and mortality after surgical lung biopsy in interstitial lung disease
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1801164
DO 10.1183/13993003.01164-2018
A1 Jolene H. Fisher
A1 Shane Shapera
A1 Teresa To
A1 Theodore K. Marras
A1 Andrea Gershon
A1 Sharon Dell
YR 2018
UL http://erj.ersjournals.com/content/early/2018/11/21/13993003.01164-2018.abstract
AB Surgical volume outcome relationships are well established but have not been studied in patients with interstitial lung disease (ILD) undergoing surgical lung biopsy. Our study objective was to determine if hospital surgical lung biopsy volume is associated with post-operative mortality in patients with ILD.A cohort study using administrative, population-based data from Ontario, Canada was performed in adults with ILD who underwent a surgical lung biopsy between 2001 and 2014. The association between yearly hospital surgical lung biopsy volume and 30-day post-operative mortality was assessed using multilevel logistic regression modeling.3057 surgical lung biopsies for ILD were performed during the study period with a median yearly hospital volume of 73 (IQR 34,143) procedures. 30-day mortality was 7.1%, 20.2% and 1.9% in overall, non-elective and elective patients, respectively. Higher yearly hospital surgical lung biopsy volume was associated with lower odds of 30-day post-operative mortality after adjusting for patient characteristics [OR 0.84 95% CI (0.73, 0.97), p=0.02)], with the association appearing stronger for non-elective procedures [OR 0.84 95% CI (0.69, 1.02), p=0.08) versus OR 0.94 95% CI (0.74, 1.18), p=0.57) in elective procedures].Higher yearly hospital surgical lung biopsy volume was associated with lower post-operative mortality in patients with ILD with the association appearing to be mainly driven by non-elective cases. Surgical lung biopsy mortality was significantly higher for non-elective cases.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Fisher reports other from University Health Network Foundation, during the conduct of the study.Conflict of interest: Dr. Shapera reports other from University Health Network Foundation, during the conduct of the study; personal fees from Astrazeneca, personal fees from Amgen, grants and personal fees from Boehringer-Ingelheim, grants and personal fees from Hoffman La-Roche, outside the submitted work.Conflict of interest: Dr. To reports grants from Ontario Ministry of Health and Long-term Care, grants from Ontario Ministry of the Environment and Climate Change, grants from CIHR (Canadian Institute for Health Research), grants from Health Canada, grants from CIHR (Canadian Respiratory Research Network), outside the submitted work.Conflict of interest: Dr. Marras reports other from University Health Network Foundation, during the conduct of the study; personal fees from Astra-Zeneca, grants and personal fees from Insmed, personal fees from Horizon, personal fees from RedHill, outside the submitted work.Conflict of interest: Dr. Gershon has nothing to disclose.Conflict of interest: Dr. Dell has nothing to disclose.