THE PHYSICIAN
Methodology: A retrospective, single-centre and observational evaluation of EBUS procedures performed between January 2018 and February 2020 was carried out. Data was collected using online hospital records. Adequacy of sample obtained and final histopathological diagnosis was assessed. Nodal staging at EBUS was compared to that of PET-CT. Results: A total of 248 patients underwent EBUSTBNA during the given time frame. 10 procedures had to be aborted without any sampling due to poor tolerance. An adequate sample was obtained in 234 cases (hit rate 98.31%). Malignant pathology was confirmed in 52.52% (125/238). 21 cases with malignancy did not undergo a PET-CT scan. In 80.76% (84/104), the EBUS and PET-CT nodal staging did not differ. The nodal staging was down-staged in 17 cases on EBUS in comparison to PET-CT. 47.48% (113/238) TBNA samples showed non-malignant pathology. 12 of these had avid lymph nodes on PET-CT which were proven non-malignant on EBUS. 4 of these cases underwent minimally invasive surgical procedures to confirm a nonmalignant diagnosis post EBUS. Conclusion: EBUS-TBNA in a secondary care centre is a useful diagnostic tool in both malignant and nonmalignant lymphadenopathy with a very high yield. EBUS nodal staging helps in confirming, and in some cases, changing the PET-CT nodal staging. This in turn impacts the management of Lung cancer Keywords: Lung cancer, Endobronchial ultrasound bronchoscopy with transbronchial needle aspiration (EBUS-TBNA), PET-CT.
OP-20. DVT prophylaxis in sixteen and seventeen-year-olds and the NICE guidelines – should adult risk assessment tools be used for children? Muhammad J; Rudge S; Mangwani J; Langford N; Best A University Hospitals of Leicester NHS Trust Correspondence to: mrjanmuhammad@gmail.com
of hospital acquired thrombosis (HAT) which extended the age range to include 16- and 17years old patients. NICE now suggests that these patients are risk assessed and receive thromboprophylaxis if indicated. We analysed the incidence of Venous Thromboembolism (VTE) in this age group over a 7-year period and found that the incidence is extremely low and often not related to risk factors commonly included in adult risk assessment tools. Methods: We retrospectively reviewed the data of 13,951 patients aged 16- and 17-years of age in our admission and imaging databases at the University Hospitals of Leicester (UHL) between 2013 and 2019 and any positive scans were screened for analysis. Results: There were 1,275 admissions and 12,676-day attendances. Of these, 145 patients had scans for suspected VTE. 13 patients had positive scans and fulfilled the inclusion criteria. Of these, 13 were excluded as either they were admitted with VTE (6) or were mislabeled entries (4). Of the remaining 3 positive scans, 1 patient had a below knee cast for fractured Calcaneus and had received VTE prophylaxis. One patient had cancer and a long line associated VTE, and 1 patient was in a below knee back slab for fracture of the Talus and was taking the Combined Oral Contraceptive Pill. Conclusion: This study shows that the risk of developing VTE in the 16- and 17-year-old age group is extremely low (overall 0.02% - 0.1% in admitted patients and 0.007% in day attenders). We question whether routine risk assessment for VTE in this age group, especially using existing adult tools, is efficacious. The guidance itself acknowledges, the evidence for prescribed drugs is lacking and the prescription for such agents being outside their Licensing Authorisation. Keywords: Thromboembolism, Thromboprophylaxis, NICE
Background and Aims: In 2018 NICE produced their guidelines with regards to the prevention
Physicianjnl.net | Vol 7 |Issue 2 | Nov 2021 | DOI 10.38192/1.7.2.bapio25.1
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