Safety and Efficacy of Flexible Bronchoscopy in Elderly Patients in Surin hospital: A Retrospective Comparative Study

Abstract

Background: Flexible bronchoscopy is a common method used for collecting diagnostic samples from the chest and lungs. Although the safety and efficacy of flexible bronchoscopy have been confirmed in the general population, data regarding its use in the elderly population remain limited. This study aims to determine the safety and efficacy of flexible bronchoscopy in elderly patients aged 70 and above.
Objective: The primary outcome compared was the rate of complications associated with bronchoscopy between elderly and non-elderly patients. Secondary outcome compare efficacy and diagnosis yield in bronchoscopy procedure between elderly and non-elderly patients.
Methods: We conducted a retrospective study on elderly patients aged 70 and above who underwent flexible bronchoscopy under fluoroscopy, compared with a non-elderly group aged 18-70 years at Surin Hospital. The study period was from January 1^st., to December 31^st., 2023. We collected data, such as complication, indications, sample collection methods, and diagnostic results of bronchoscope to analyzed.
Results: A total of 168 patients were included in this study, with 40 patients in the elderly group and 128 patients in the non-elderly group. The diagnostic yield of bronchoscopy was evaluated across different age groups. Among elderly patients, 35 out of 40 individuals (87.5%) received a definitive diagnosis through bronchoscopy. Similarly, in the non-elderly group, 113 out of 128 patients (88.3%) were successfully diagnosed using the same method. The difference in diagnostic yield between the two groups was not statistically significant. The most common indication for bronchoscopy was the presence of a lung mass or nodule, which was more frequent in the elderly group (30 patients, 75.6%) compared to the non-elderly group (78 patients, 60.9%) (p =0.093), though this difference was not statistically significant. But Infection-related indications were more common in the non-elderly group (50 patients, 39.1%) compared to the elderly group (10 patients, 25.0%) (p = 0.04), which was statistically significant. Bronchoscopy with bronchoalveolar lavage (BAL) was performed more frequently in the non-elderly group (14 patients, 10.9%) compared to the elderly group (1 patient, 2.5%) (p = 0.04), which was also statistically significant. There were no deaths related to the bronchoscopy procedure, and other secondary outcomes include the incidence of complication such as bleeding, hypoxia, pneumothorax, fever, or pneumonia were no statistically significant difference.
Conclusion: The results of this study indicate that flexible bronchoscopy can be perform effectively and safely in elderly patients aged 70 years and older, similar to non-elderly patients.