Abstract: Poster Presentations |

Flexible Bronchoscopy in the Elderly Patient FREE TO VIEW

Prasoon Jain, FCCP,; Ismail Al-Ani, MD
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Louis A Johnson VA Medical Center, Clarksburg, WV


Chest. 2003;124(4_MeetingAbstracts):144S. doi:10.1378/chest.124.4_MeetingAbstracts.144S-b
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PURPOSE:  It is not known how often flexible bronchoscopy (FB) changes management in elderly patients. We studied the clinical utility and safety of flexible bronchoscopy in patients 75 years or older.

METHODS:  Computerized records of 61 elderly patients who under-went FB over a 4-year period were reviewed retrospectively. Demographic information, co-morbid conditions, indications and details of procedure, diagnosis from FB, procedural complications and management changes due to FB results were recorded.

RESULTS:  Median age was 78 years (range 75-88). Twenty-two patients (36%) were 80 years or older. FB was performed for lung mass in 29 (48%), non-resolving infiltrate in 11 (18%), and hemoptysis in 9 (15%) patients. The majority of patients were smokers; 64% had chronic obstructive pulmonary disease; 39% had coronary artery disease; 25% had congestive heart failure and 18% were receiving home oxygen. FB was performed in an outpatient setting in 44 (72%) patients. Brushing was done in 43 (70%), transbronchial biopsy in 26 (43%), endobronchial biopsy in 24 (39%), and transbronchial needle aspiration in 11 (18%) patients. Multiple sampling procedures were performed in 53 (87%) patients. FB provided diagnosis in 44 (72%; 95% confidence interval [CI] 60-82%) patients. Lung cancer was the most common diagnosis from FB (26 patients; 43%). Management changes due to FB occurred in 29 (48%; 95% CI 36-60%) patients, including initiation of radiation therapy in 11 (18%), chemotherapy in 9 (15%), and surgery in 3 (5%) patients. Procedure-related complications were observed in 7 (11%; 95% CI 5-21%) patients. Majority of complications were minor and there were no deaths after the procedure.CONCLUSIONS: FB is safe, frequently provides diagnosis, and leads to important management changes in elderly patients.

CLINICAL IMPLICATIONS:  Advanced age by itself is not a contraindication for FB.

DISCLOSURE:  P. Jain, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM




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