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Weather Not a Factor in Pneumothorax Risk with Lung Biopsy

Weather Not a Factor in Pneumothorax Risk with Lung Biopsy

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Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  • Whether the weather was stormy or bright, it didn’t appear to have any impact on the occurrence of pneumothorax or tube placement in patients undergoing percutaneous image-guided biopsy collection among people with suspected lung cancer.
  • Note that the study would not change recommendations regarding avoidance of airline travel immediately following percutaneous lung biopsies.

CHICAGO – Whether the weather was stormy or bright, it didn’t appear to have any impact on the occurrence of pneumothorax or tube placement in patients undergoing percutaneous image-guided biopsy collection among people with suspected lung cancer, according to a single-center study reported here.

In a retrospective study that matched weather conditions with records of surgical complications, Divya Sridhar, MD, of NYU Langone Health in New York City, said there was no correlation between the incidence of pneumothorax and the outside temperature, humidity, or atmospheric pressure over an approximately 3-year period at her center.

In her oral presentation at the annual scientific sessions of the Radiological Society of North America, Sridhar said her findings “deflated” the myth that weather conditions might play some role in causing pneumothorax and/or the seriousness of the event.

She did note, however, that during the time of her study, there were no hurricanes or tornadoes in the New York City area – so the work might not rule out an effect from extreme weather conditions. She also said her study could not change recommendations regarding avoidance of airline travel immediately following percutaneous lung biopsies. Sridhar said she does advise her patients who have recently undergone such procedures to avoid commercial airline flights.

Sridhar said there have been numerous anecdotal reports of the clustering of serious pneumothorax cases – those requiring drainage tubes – around certain weather conditions, but previous reports that indicate a problem when atmospheric pressure is low and often heralding a storm have had mixed results.

“To our knowledge, this study is the first to examine the correlation between meteorological conditions and the incidence of pneumothorax after CT-guided lung biopsy,” she said at RSNA meeting.

Session co-moderator Hyun Kim, MD, chief of interventional radiology at the Yale School of Medicine, New Haven, Connecticut, told MedPage Today, “I really don’t think doctors worry about the weather outside when they are performing percutaneous lung biopsies. However, the concept is that atmospheric pressure makes the complication rate different. So it is an interesting question.”

To perform the study, Sridhar and colleagues included consecutive CT-guided lung nodule biopsies performed by board-certified interventional radiologists or interventional radiology fellows from December 2011 to May 2014 – more than 900 days – at a single academic center, with 368 biopsies on 368 patients during that period. Weather information was missing in the cases of 30 of those patients, leaving the researchers with a cohort of 338 patients for their analysis. Records indicated a total of 115 pneumothorax episodes in this group.

The medical information regarding how the procedures were performed and various complications and the seriousness of those complications were married with meteorological data accessed from National Oceanic and Atmospheric Administration website, using weather data accrued at the Central Park Station in Manhattan – located within 3 miles of the hospital.

There were no special weather conditions when 135 of the patients who did not have a pneumothorax under went their procedure and 80 of the patients who did have a pneumothorax were treated; rainfall occurred when 70 of the people who did not have a pneumothorax were treated and when 32 patients experienced pneumothorax; it was snowing when 11 patients without a pneumothorax underwent their biopsy, and there were three patients who underwent the procedure and had a pneumothorax. Overall, Sridhar said there was no statistically significant difference (P=0.213).

When she compared those patients with pneumothorax to whether drainage tube placement was required, there was no statistically significant differences either as to whether the sun was out or it was raining or snowing. Humidity outside also had no impact on pneumothorax occurrence or the need for a drainage tube.

In fact, when the research team scrutinized their data only one aspect of the procedure popped out as being statistically significant – the size of the nodule being biopsied. Smaller nodules were associated with significantly greater risk of complications, she said.

“Our study indicates there is no need to rearrange lung biopsy schedule based on thunderstorms, The Weather Channel, or Poor Richard’s Almanac,” Sridhar joked.

Sridhar and Kim disclosed no relevant relationships with industry.

  • Reviewed by
    Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco


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