PURPOSE: The prevalence, safety and efficacy of bronchoscopic removal of foreign bodies in the advanced elderly, defined as age > 75 years, are unknown. We wished to define the risk and establish the overall safety and effectiveness of flexible bronchoscopy in the removal of foreign bodies in this patient population compared to those who are younger.
METHODS: We performed a retrospective case control analysis of 7089 adults (age greater than 18 years), including 949 (15%) advanced elderly (age > 75 years), who underwent bronchoscopy at a tertiary academic hospital. In those patients with Foreign Body Aspiration (FBA) (n=20) we compared multiple clinical characteristics based on defined age groups (Group 1, age < 75 years and Group 2, age > 75 years).
RESULTS: FBA as an indication for bronchoscopy was three and a half times more likely in patients age > 75 years compared to those age <75 years (OR 3.78, CI 1.4–10: p<0.05). Flexible bronchoscopy was 87.5% effective in the removal of foreign bodies in the advanced elderly and associated with no significant increase in adverse events.
CONCLUSION: Advanced elderly patients are more likely to undergo flexible bronchoscopy for FBA. This suggests that this population is at an increased risk of FBA in general. There should be an increased clinical awareness by physicians who care for advanced elderly patients. Flexible bronchoscopy is a safe and effective diagnostic and therapeutic approach in the removal of foreign bodies in the advanced elderly.
CLINICAL IMPLICATIONS: The prevalence of bronchoscopy for the removal of foreign bodies in the advanced elderly is high and therefore clinical suspicion should be high. Early recognition and removal of foreign bodies is paramount in preventing complications in the advanced elderly, and flexible bronchoscopy is a safe and reasonable initial diagnostic and therapeutic approach in this age group.
DISCLOSURE: Michael Boyd, No Financial Disclosure Information; No Product/Research Disclosure Information