RELIABILITY OF BRONCHOSCOPICPROCEDURES IN VERY ELDERLY PATIENTSAND THE ROLE OF CHARLSON COMORBIDITYSEVERITY INDEX ON PREDICTINGBRONCHOSCOPIC COMPLICATIONS

Abstract

Introduction:Inthisstudy,weaimedtoevaluatethecomplicationsofbronchoscopy in patients aged 75 years and above and to investigate the role of comorbidities on the complications.Materials and Method: All bronchoscopic procedures performed between September 2017 and September 2019 in our bronchology unit on patients aged over75yearswereevaluatedretrospectively.Characteristicsofpatientsandbronchoscopic procedures were recorded. Charlson Comorbidity Severity Index was calculated for each patient.Results: Bronchoscopicprocedureswereperformedon272patients.Theaverage age was 78.6±3.8 years (min:75-max:92). 194 (71.3%) flexible fiberoptic bronchoscopy procedures, 68 (25%) endobronchial ultrasonographic procedures, and 10 (3.7%) rigid bronchoscopy procedures were performed. One or more comorbidities were present in 238 (87.5%) patients. The most common comorbidity was cardiovascular disease. There were 236 (86.7%) patients using one or more medications. One or more complications rates were %5,8 (16/272). The complication rates were 5.7% in the low (≤6) comorbidity severity index group versus 6.4% in the high (>6) comorbidity severity index group, and there was no statistical significance between the two groups (p=0.829). There is no mortality. Only one patient developed hypoxia and respiratory acidosis required noninvasive mechanic ventilation.Conclusion: In summary, bronchoscopic procedures are very safe in patients with advanced age who had ≥1 comorbidities and high CCSI. Although CCSI helps in predicting complications and mortality in many diseases, it was not seen to contribute to predicting bronchoscopic complications. Although bronchoscopy rarely causes complications in the elderly, more prospective cohort studies on more detailed and specific indices are needed to predict these complications.