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Background <p>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely used minimally invasive technique for the diagnosis of mediastinal and hilar lymphadenopathies and for staging of lung cancer. Although generally considered safe, bleeding remains one of the most common procedure-related complications. Thyroid dysfunction is known to influence several components of the hemostatic system; however, its potential impact on bronchoscopic procedure related bleeding has not been sufficiently investigated. This study aimed to evaluate the association between thyroid function and bleeding complications during EBUS-TBNA.</p> Methods <p>This retrospective study included 334 patients who underwent EBUS-TBNA between January 2018 and January 2025 at a tertiary referral center. Patients with available thyroid function tests (TSH, free T3, and free T4) prior to the procedure were included. Bleeding events were categorized as no bleeding or bleeding (grade 1–3) based on procedural records. Demographic, clinical, laboratory, and procedural characteristics were compared between groups. Univariate and multivariate logistic regression analyses were performed to identify factors associated with bleeding complications.</p> Results <p>The mean age of the patients was 65 ± 13&#xa0;years, and 232 (69.5%) were male. Bleeding complications occurred in 166 patients (49.7%), while 168 patients (50.3%) had no bleeding during the procedure. Female sex (OR = 1.77, p = 0.035), presence of comorbidity (OR = 2.38, p = 0.009), DOAC use (OR = 4.48, p = 0.035), multiple lymph node sampling (OR = 2.37, p = 0.018), and thyroid dysfunction (OR = 3.31, p &lt; 0.001) were independently associated with bleeding complications in multivariate Model 1. In Model 2, elevated TSH levels (OR = 3.99, p &lt; 0.001) remained an independent predictor of bleeding.</p> Conclusion <p>Thyroid dysfunction was independently associated with bleeding complications during EBUS-TBNA. Elevated TSH levels were also identified as an independent predictor of bleeding risk. Assessment of thyroid function status may contribute to improved pre procedural risk stratification in patients undergoing bronchoscopic interventions.</p>

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Impact of Thyroid Dysfunction on Bleeding Risk During Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Güzide Tomas,
  • Harun Çıtlak,
  • Şeyma Başlılar,
  • Mustafa Düger

摘要

Background

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely used minimally invasive technique for the diagnosis of mediastinal and hilar lymphadenopathies and for staging of lung cancer. Although generally considered safe, bleeding remains one of the most common procedure-related complications. Thyroid dysfunction is known to influence several components of the hemostatic system; however, its potential impact on bronchoscopic procedure related bleeding has not been sufficiently investigated. This study aimed to evaluate the association between thyroid function and bleeding complications during EBUS-TBNA.

Methods

This retrospective study included 334 patients who underwent EBUS-TBNA between January 2018 and January 2025 at a tertiary referral center. Patients with available thyroid function tests (TSH, free T3, and free T4) prior to the procedure were included. Bleeding events were categorized as no bleeding or bleeding (grade 1–3) based on procedural records. Demographic, clinical, laboratory, and procedural characteristics were compared between groups. Univariate and multivariate logistic regression analyses were performed to identify factors associated with bleeding complications.

Results

The mean age of the patients was 65 ± 13 years, and 232 (69.5%) were male. Bleeding complications occurred in 166 patients (49.7%), while 168 patients (50.3%) had no bleeding during the procedure. Female sex (OR = 1.77, p = 0.035), presence of comorbidity (OR = 2.38, p = 0.009), DOAC use (OR = 4.48, p = 0.035), multiple lymph node sampling (OR = 2.37, p = 0.018), and thyroid dysfunction (OR = 3.31, p < 0.001) were independently associated with bleeding complications in multivariate Model 1. In Model 2, elevated TSH levels (OR = 3.99, p < 0.001) remained an independent predictor of bleeding.

Conclusion

Thyroid dysfunction was independently associated with bleeding complications during EBUS-TBNA. Elevated TSH levels were also identified as an independent predictor of bleeding risk. Assessment of thyroid function status may contribute to improved pre procedural risk stratification in patients undergoing bronchoscopic interventions.