Prevalence of flexible bronchoscopic removal of foreign bodies in the advanced elderly

OBJECTIVES: to define the likelihood and establish the overall safety and effectiveness of flexible bronchoscopy in the removal of foreign bodies in the advanced elderly compared to those younger. DESIGN: a retrospective case-control analysis. SETTING: tertiary care academic hospital. POPULATION: 7,089 adults (age >18 years), including 949 (15%) advanced elderly (age >75 years), who underwent flexible bronchoscopy between January 1995 and June 2007. MEASUREMENTS: in those patients with foreign body aspiration (FBA) (n = 20), a comparison of multiple clinical characteristics based on defined age groups (group 1, age <75 years and group 2, age >75 years) was performed. RESULTS: FBA requiring bronchoscopic removal was greater than three and a half times more likely in patients aged >75 years compared to those younger (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 increase in adverse events. CONCLUSION: bronchoscopic removal of foreign bodies is more likely in the advanced elderly when compared to those younger. This implies that this population may be most at risk. Flexible bronchoscopy is a safe and effective initial diagnostic and therapeutic approach in this age group.