Bronchoscopic Procedures in Octogenarians

The objective of this retrospective case-control study was to evaluate the attendant risks and diagnostic yield of bronchoscopic procedures performed in octogenarians relative to a non-octogenarian group. Reports from 107 octogenarians who were seen in the pulmonary medicine clinic of a tertiary referral medical center were identified and extracted from a bronchoscopic database in conjunction with 121 randomly extracted non-octogenarian cases for comparison. Interventional procedures included bronchoscopy with or without adjunctive biopsy procedures. There was no statistically significant difference in leading procedural indications, number of adjunctive biopsy procedures, complication rates, or diagnostic yield between octogenarians and non-octogenarians. A significantly lower mean fentanyl dosage was used in octogenarians relative to non-octogenarian cohorts. Despite the lower mean dosages of 1 of 2 conscious sedation agents, octogenarians experienced a predominant complication of oversedation. Our data support the safety and efficacy of bronchoscopy in octogenarians. These results also suggest a possible note of caution regarding the dosing of sedatives and analgesics in octogenarians and the need for prospective data on the institution of sedation protocols in this particular age group.