Abstract Background: Flexible bronchoscopy (FB) is an essential diagnostic tool in pediatric airway disorders; however, the reported diagnostic yields and safety profiles vary widely across centers, and contemporary data from low- and middle-income settings remain limited. This study evaluated the diagnostic yield, management impact, and safety profile of FB in children at a tertiary-care center in Eastern India. Methods: We conducted a retrospective observational study of children aged 0–16 years who underwent FB for airway-related indications between January 2018 and December 2023. Indications, bronchoscopic findings, bronchoalveolar lavage (BAL) results, complications, and post-procedure management changes were analyzed. The diagnostic yield was stratified into (1) definitive structural/pathological diagnoses and (2) management-altering findings. Outcomes are reported with 95% confidence intervals (CIs). Results: A total of 230 procedures were performed in 218 children (median age: 18 months interquartile range: 6–48; 62% male). The overall diagnostic yield was 74% (95% CI: 68.0–79.3). Definitive structural or pathological diagnoses were established in 56% (95% CI: 49.5–62.4), and management-altering findings were observed in 58% (95% CI: 51.6–64.4). BAL contributed to diagnosis in 41% of procedures. The yield was highest in suspected foreign body aspiration and focal atelectasis. Predominantly minor and transient procedure-related complications occurred in 9.6% (95% CI: 6.3–13.9). Major complications occurred in 1.3% (95% CI: 0.3–3.8), without long-term sequelae. Conclusions: FB demonstrated high diagnostic yield and meaningful clinical impact with a low rate of serious complications. These findings support its safe and effective use in experienced tertiary-care pediatric centers and underscore the importance of standardized procedural protocols.
Halder et al. (Thu,) studied this question.