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Multicenter Study
. 2023 Feb;59(2):84-89.
doi: 10.1016/j.arbres.2022.10.007. Epub 2022 Nov 1.

Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study

[Article in English, Spanish]
Pere Serra Mitjà  1 , Filipe Gonçalves Dos Santos Carvalho  2 , Ignasi Garcia Olivé  3 , José Sanz Santos  4 , Jesús Jiménez López  5 , Ana Núñez Ares  5 , Laura Tomás López  6 , Carmen Centeno Clemente  3 , Rachid Tazi  3 , Eva Castellà  2 , Jorge Abad Capa  7 , Antoni Rosell Gratacós  7 , Felipe Andreo Garcia  7
Affiliations
Multicenter Study

Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study

[Article in English, Spanish]
Pere Serra Mitjà et al. Arch Bronconeumol. 2023 Feb.

Abstract

The aim of our study was to describe the incidence of infectious complications of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and to analyze the potential risk factors in a prospective cohort of patients.

Methods: We conducted a prospective multicenter study, with all consecutive patients referred for an EBUS-TBNA with patients at risk of developing an infectious complication (considering>10 nodal samplings, known immunosuppression, bronchial colonization and cavitated or necrotic lesions) and a second group without any risk factor.

Results: Three hundred seventy patients were included: 245 with risk factors and 125 without risk factors (as the control group). Overall, 15 patients (4.05%) presented an acute infectious complication: fourteen in cases (5.7%) and 1 in controls (0.8%). Of these, 4 patients presented pneumonia, 1 mediastinitis, 4 obstructive pneumonitis and 6 mild complications (respiratory tract infection that resolved with antibiotic). Also 7 (1.9%) patients had self-limited fever. One-month follow-up showed 1 mediastinitis at sixteenth day post-EBUS, which required surgical treatment, and 3 pneumonias and 3 respiratory tract infections at nineteenth day (1.9%). All patients had a good evolution and there were no deaths related with infectious complication. We observed an increased risk of complication in patients with risk factors and in patients with necrosis (p=0.018).

Conclusions: The incidence of infectious complications in a subgroup of patients with risk factors was higher than in patients without risk factors. Nevertheless, it remains low, and no fatal complication occurred, which reinforces the idea that EBUS-TBNA is a safe technique for the assessment of the mediastinum. Necrotic lesions are a risk factor of post-EBUS infection, and their puncture should be avoided.

Keywords: EBUS complications; EBUS risk factors; EBUS safety; Endoscopic ultrasonography; Infectious complications.

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