Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) in Moderate Sedation in Patients Aged 80 Years and Older

Background/Objectives: The utility and safety of EBUS-TBNA in the general population are well-documented in the scientific literature, but data on elderly patients, particularly those over 80 years old, are limited. Methods: We retrospectively investigated patients aged 80 and over who underwent EBUS-TBNA under moderate sedation, without anesthesiologic assistance, over a period of seven years at a single Italian hospital. The primary outcome was the safety of the procedure assessed by evaluating the complication rate occurring during the procedure and up to one week afterward. Secondary outcomes included the rate of procedures with successful sampling, the percentage of procedure repeated with anesthesiologic assistance, specimen adequacy, overall diagnostic yield, type of diagnosis, malignancy rate and the percentage of patients who underwent active treatment after obtaining an oncological diagnosis. Results: A total of 141 patients were enrolled in the study; the mean age was 82.6 ± 2.2 years. The incidence of complications was 11.3% (16/141); most adverse events were mild (9.9% 14/141). Two patients (1.4%) experienced major complications requiring hospitalization. Regarding the secondary endpoints, sampling was successfully performed in 99.3% of cases (140/141); in one case, it was necessary to repeat the procedure with anesthesiologic assistance (0.7% 1/141). Specimens were adequate in 96.4% of cases (135/140); the overall diagnostic rate was 85.7% (120/140); the malignancy rate was 52.9% (74/140) and among these, 78.4% (58/74) were treated. Conclusions: EBUS-TBNA performed under moderate sedation is a safe and diagnostically effective procedure in patients older than 80 years of age, supporting its use in this growing population.