The Elderly Tolerate Fiberoptic Bronchoscopy as Well as Younger Patients

The safety and tolerance of flexible fiberoptic bronchoscopy (FFB) was compared between elderly and younger patients. Before undergoing FFB, the patient's history, arterial blood gas (ABG levels), and spirometry were recorded. During the test, patients were monitored with pulse oximetry and with an electrocardiogram. Coughing during the FFB was recorded on a taperecorder. Finally, when the patients had recovered they were asked to evaluate the degree of discomfort associated with FFB using a categorical value scale. Ninety-five patients undergoing FFB were studied; 47 of whom were 66 of age years or older (range, 66–84 years). During the FFB one patient had significant hemoptysis (∼300 ml) after a bronchial biopsy. One patient developed tachycardia after atropine administration, before FFB. Oxygen desaturation occurred in 20 ± 23% procedures, 13 ± 65% of these were in younger patients (p = 0.1), although only once was the FFB stopped. The elderly patients had a lower cough frequency, 3.1 ± 2.9 coughs per minute compared to 4.9 ± 2.8 in the younger patients (p < 0.005). Using a comfort scale of 0–10, on average, the elderly rated the test as tolerable (mean CVS score 2.8 ± 2.9) and the younger patients gave a similar assessment (mean CVS score 2.7 ± 3). Eighty-seven percent of all the patients stated that they would have a repeat FFB, further indicating that the test was well tolerated. Thus, FFB is safe in older patients, is well tolerated, and in comparison to younger patients FFB is associated with less coughing and oxygen desaturation.