Original articleGeneral thoracicDiagnostic Surgical Lung Biopsies for Suspected Interstitial Lung Diseases: A Retrospective Study
Section snippets
Patient Identification
All patients undergoing SLB for suspected ILD during a 22-year period between January 1, 1986, and December 30, 2007, were identified through two registries separately. During the study period, the average number of people living in Iceland was 273,052 (minimum of 242,203 in 1986, maximum of 315,459 in 2007; Icelandic National Registry).
A computerized diagnosis and operation registry was used to identify patients undergoing open or thoracoscopic lung biopsy at Landspitali University Hospital
Results
During the 22-year study period a total of 73 patients underwent an SLB for suspected ILD in Iceland, on average 3.3 patients per year with a range of 0 to 10 per year. The average age at diagnosis was 57.3 years (range, 20 to 88 years) and the number of men (58%) and women (42%) did not differ statistically (p = 0.20). A vast majority of the population had a history of smoking (75%), with 53% of the patients being heavy smokers (>20 pack-years).
The dominant presenting symptoms were dyspnea in
Comment
In this nationwide retrospective study we found that SLB is diagnostic for specific disease in 81% of our patients and that treatment strategy was changed for every other patient. We have addressed several unreported but important issues related to SLB in suspected ILD, such the diagnostic yield of the biopsy, how often it changes the diagnosis, and how often treatment is changed.
Our 73% ratio of changed diagnosis is higher than the 49% reported by Lettieri and associates [10] in their series
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