A meta-analysis examining the risk factors associated with pneumothorax during CT-guided percutaneous lung biopsy

Background: The study aimed to systematically evaluate the risk factors for pneumothorax after computed tomography (CT)-guided percutaneous lung biopsy. Materials and Methods: We conducted a search of several databases, including PubMed, Embase, the Cochrane Library, Web of Science, and CNKI, until May 2021, focusing on research related to risk factors for pneumothorax following CT-guided percutaneous lung biopsy. After screening and extracting the data, we conducted a meta-analysis using RevMan software (version 5.3) to calculate the odds ratio (OR) and 95% confidence interval (CI) for each relevant risk factor. Statistical significance was set at P<0.05. Results: Our study included 28 articles and 16,667 patients who underwent CT-guided lung biopsy, of whom 4,566 patients developed pneumothorax (27.40%). Our results showed that the incidence of pneumothorax was lower in the group with pulmonary nodules >= 2 cm, and the difference was statistically significant (OR=0.61, 95% CI=0.43-0.86, P=0.004). Additionally, patients with emphysema had a higher risk of developing a pneumothorax after the procedure, and the difference was statistically significant (OR=2.5, 95% CI=1.62-3.87, P<0.0001). Correlation analysis of sex, lung nodule size, needle track length, and CT-guided lung nodule biopsy showed no significant differences (P>0.05). Conclusion: Our findings indicate that pulmonary nodules smaller than 2 cm and emphysema significantly increase the risk of pneumothorax after puncture. Clinicians should be vigilant in monitoring patients with these risk factors after the procedure.