Chest
Volume 122, Issue 4, October 2002, Pages 1461-1464
Journal home page for Chest

Bronchoscopy
Aspirin Does Not Increase Bleeding Complications After Transbronchial Biopsy

https://doi.org/10.1378/chest.122.4.1461Get rights and content

Study objectives

The present study was performed to determine whether the risk of bleeding after transbronchial lung biopsy is increased in patients taking aspirin.

Patients and interventions

After excluding patients with other coagulation problems, 1,217 patients who had undergone transbronchial lung biopsy during a prospective 1.5-year study period were included in this study. The use of aspirin was not discontinued before the procedure. Two hundred eighty-five patients (23%) had consumed aspirin within 24 h of the procedure, and most of them (82%) used aspirin on a daily basis. Transbronchial biopsies were performed, and the bleeding incidence was compared between the groups.

Results

A total of 57 patients (4.7%) experienced procedure-related bleeding. Minor bleeding occurred in 5 of 285 patients (1.8%) taking aspirin and in 27 of 932 control patients (2.9%; not significant). Moderate bleeding was seen in 3 of 285 patients (1.1%) in the aspirin group and in 13 of 932 patients (1.4%) in the control group (not significant). Major bleeding occurred in only 9 patients, 2 of 285 (0.9%) in the aspirin group and 7 of 932 (0.8%) in the control group (not significant). All bleeding was controlled by endoscopic means, and there were no fatalities and no need for blood transfusions.

Conclusions

We conclude that the risk of severe bleeding after transbronchial lung biopsy is small (ie, < 1%) and that the use of aspirin is not associated with any increased risk of bleeding.

Section snippets

Study Population

All patients > 40 years of age undergoing bronchoscopy with TBBX during a 1.5-year period from July 1999 through January 2001 were evaluated. Patients were excluded from enrollment into the study if one of the following conditions existed: (1) the patient had received either warfarin or heparin therapy within 2 weeks of the endoscopic procedure; (2) the patient had a known history of a bleeding disorder; or (3) the patient had thrombocytopenia with a platelet count of < 80,000 cells/μL. The

Results

A total of 1,217 patients who had undergone bronchoscopy with TBBX satisfied the entry criteria and agreed to participate in this study. Of these patients, 285 (23%) had taken aspirin within 24 h of undergoing the endoscopic procedure, and 82% of these patients were taking aspirin on a daily basis and continued to do so after undergoing the endoscopic procedure. The most common reason for taking aspirin was primary or secondary prevention of coronary heart disease and the prevention of graft

Discussion

The use of aspirin is indicated for many conditions and has been found to be beneficial in many cardiovascular diseases. Frequently, the indicated use of this medication is interrupted for days if a patient is scheduled for elective TBBX, as has been recommended by some practitioners.13

Only very few studies have addressed the issue of coagulation defects and their influence on complications after endoscopic procedures.14 Interestingly, a study by Brickey and Lawlor15 in pigs treated with

References (15)

There are more references available in the full text version of this article.

Cited by (120)

  • Bronchoscopy

    2021, A Medication Guide to Internal Medicine Tests and Procedures
View all citing articles on Scopus
View full text