Impact of Cough Severity on the Diagnostic Yield of Endobronchial Ultrasonography Transbronchial Biopsy with Guide Sheath: A Retrospective Observational Study
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Published:2024-01-08
Issue:2
Volume:13
Page:347
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ISSN:2077-0383
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Container-title:Journal of Clinical Medicine
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language:en
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Short-container-title:JCM
Author:
Kobayashi Fumi1, Saraya Takeshi1ORCID, Akizawa Takatora1, Abe Taro1, Takagi Ryo1, Ieki Eriko1, Ishikawa Narishige1, Kurokawa Nozomi1, Aso Jumpei1, Nunokawa Hiroki1, Nakamoto Yasuo1, Ishida Manabu1, Sada Mitsuru1, Nakamoto Keitaro1ORCID, Takata Saori1, Ishii Haruyuki1
Affiliation:
1. Department of Respiratory Medicine, Faculty of Medicine, Kyorin University, Tokyo 181-8611, Japan
Abstract
Bronchoscopy is an invasive procedure, and patient coughing during examination has been reported to cause patient distress. This study aimed to clarify the relationship between cough severity and diagnostic yield of endobronchial ultrasonography with guide sheath transbronchial biopsy (EBUS-GS-TBB). Data of patients who underwent bronchoscopy at Kyorin University Hospital between April 2019 and March 2022 were retrospectively evaluated. Bronchoscopists assessed the cough severity upon completion of the procedure using a four-point cough scale. Cough severity was included as a predictive factor along with those reportedly involved in bronchoscopic diagnosis, and their impact on diagnostic yield was evaluated. Predictors of cough severity were also examined. A total of 275 patients were enrolled in this study. In the multivariate analysis, the diagnostic group (n = 213) had significantly more ‘within’ radial endobronchial ultrasound findings (odds ratio [OR] 5.900, p < 0.001), a lower cough score (cough score per point; OR 0.455, p < 0.001), and fewer bronchial generations to target lesion(s) (OR 0.686, p < 0.001) than the non-diagnostic group (n = 62). The predictive factors for severe cough include the absence of virtual bronchoscopic navigation (VBN) and prolonged examination time. Decreased cough severity was a positive predictive factor for successful EBUS-GS-TBB, which may be controlled using VBN and awareness of the procedural duration.
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