{ "abstract": "Background/Objectives: Electromagnetic navigational bronchoscopy (ENB) and CT-guided transthoracic needle biopsy (TTNB) are established approaches to sampling peripheral pulmonary lesions. Comparative real-world data on procedure-associated pleural complications and hospital resource use remain limited. We compared coded pleural complications, length of stay, hospital costs and reimbursement after ENB versus TTNB in German inpatient care. Methods: This retrospective multicentre analysis used fully anonymised administrative hospital cost and reimbursement data from nine German hospitals between January 2023 and December 2024. Of 2904 inpatient cases (590 ENB and 2314 TTNB), 536 matched pairs were generated by 1:1 nearest-neighbour propensity-score matching without replacement using age and sex, with exact matching on adjacent diagnosis-related group (ADRG2). Outcomes were coded pneumothorax, coded pneumothorax requiring chest-tube drainage, length of stay, total hospital costs and reimbursement. Results: In the matched cohort, mean age was 68.2 ± 10.6 years after TTNB and 68.5 ± 10.4 years after ENB; the male-to-female ratio was 1.34 and 1.36, respectively. Coded pneumothorax occurred less frequently after ENB than after TTNB (4.1% vs. 13.1%); in matched-pair logistic regression, ENB was associated with lower odds of coded pneumothorax (OR 0.28, 95% CI 0.17–0.47; p < 0.001). Coded pneumothorax requiring chest-tube drainage occurred in 3.4% versus 12.9%, respectively. Median length of stay was shorter after ENB (2 [IQR 1–4] vs. 3 [1–8] days; p < 0.001), whereas median hospital costs were higher (€5793 [4670–7466] vs. €3739 [1995–7514]; p < 0.001). Median reimbursement was €3366 in both groups (p = 0.186). Conclusions: In this German inpatient cohort, ENB was associated with fewer coded pleural complications and shorter hospital stays than TTNB, but with higher hospital costs despite similar reimbursement. These findings characterise system-specific inpatient resource use and do not establish comparative clinical superiority or cost-effectiveness.", "abstract_shown": true, "affiliations": [ "Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany", "German Center for Lung Research (DZL), 10117 Berlin, Germany", "Capnetz Foundation, 30625 Hannover, Germany", "Administrative Office for Clinical Quality and Risk Management, Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany", "Department of Radiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany", "Medizinische Klinik V, Universitätsklinikum Jena, 07747 Jena, Germany", "Klinik für Innere Medizin, Pneumologie und Gastroenterologie, Pius-Hospital Oldenburg, 26121 Oldenburg, Germany", "Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein (UKSH), 23538 Lübeck, Germany", "Airway Research Center North (ARCN), German Center for Lung Research (DZL), 23538 Lübeck, Germany", "Klinik für Pneumologie und Intensivmedizin, Klinikum St. Georg Leipzig, 04129 Leipzig, Germany", "Fachklinik Pneumologie, Thoraxchirurgie und Allergologie, Johanniterkrankenhaus Treuenbrietzen, 14929 Treuenbrietzen, Germany", "Klinik für Pneumologie, Infektiologie und Internistische Intensivmedizin, Klinikum Dortmund, 44145 Dortmund, Germany", "Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Evangelische Kliniken Essen-Mitte gGmbH, 45276 Essen, Germany", "Medizinische Klinik, Städtisches Krankenhaus Kiel, 24116 Kiel, Germany", "Inspiring-Health GmbH, 80935 Munich, Germany" ], "article_type": null, "arxiv": null, "author_total": 20, "authors": [ { "affs": [ 0 ], "name": "Jacopo Saccomanno", "orcid": "0009-0005-0188-7541" }, { "affs": [ 0, 1, 2 ], "name": "Martin Witzenrath", "orcid": "0000-0002-9787-5633" }, { "affs": [ 0 ], "name": "Nikolaj Frost", "orcid": "0000-0001-7452-7129" }, { "affs": [ 3 ], "name": "Ralf Hammerich", "orcid": "0000-0002-5853-190X" }, { "affs": [ 4 ], "name": "Thomas Elgeti", "orcid": "0000-0002-7155-6044" }, { "affs": [ 5 ], "name": "Susanne Lang", "orcid": "0000-0003-1332-9879" }, { "affs": [ 5 ], "name": "Carolin Kraska" }, { "affs": [ 2, 6 ], "name": "Dominic Dellweg" }, { "affs": [ 7 ], "name": "Patrick Parschke" }, { "affs": [ 8, 9 ], "name": "Daniel Drömann" }, { "affs": [ 9 ], "name": "Goran Mitkovski" }, { "affs": [ 10 ], "name": "Konrad Wetzer" }, { "affs": [ 10 ], "name": "Olaf Schega" }, { "affs": [ 11 ], "name": "Stephanie Burian" }, { "affs": [ 12 ], "name": "Stefan Morgenstern" }, { "affs": [ 13 ], "name": "Burkhard Bewig" }, { "affs": [ 14 ], "name": "Karina Kleinschnitz" }, { "affs": [ 14 ], "name": "Wolfgang Heinlein" }, { "affs": [ 14 ], "name": "Markus Rathmayer" }, { "affs": [ 0 ], "name": "Ralf-Harto Hübner" } ], "bibtex": "https://research.draconitic.com/paper/c38jc0h0vgzs5.bib", "cited_by": 0, "doi": "10.3390/jcm15218648", "fulltext_url": null, "id": "c38jc0h0vgzs5", "issns": [ "2077-0383" ], "landing_url": "https://www.mdpi.com/2077-0383/15/21/8648", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [], "openalex": null, "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-11-06", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/c38jc0h0vgzs5.ris", "sources": [ { "first_seen": "2026-11-07T00:21:23Z", "native_id": "10.3390/jcm15218648", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/21/8648" } ], "subjects": [ { "field": "medicine", "origin": "journal-openalex:F27", "subfield": "general" } ], "title": "Hospital Costs and Pleural Complications of Electromagnetic Navigational Bronchoscopy Versus CT-Guided Transthoracic Needle Biopsy: A German Multicentre Matched Analysis", "title_text": "Hospital Costs and Pleural Complications of Electromagnetic Navigational Bronchoscopy Versus CT-Guided Transthoracic Needle Biopsy: A German Multicentre Matched Analysis", "type": "peer-reviewed", "updated_at": "2026-11-08T00:23:02Z", "url": "https://research.draconitic.com/paper/c38jc0h0vgzs5", "venue": "Journal of Clinical Medicine", "versions": [] }