Indications, clinical outcomes and complications of 1,949 flexible bronchoscopies
ABSTRACT Objective To describe indications, clinical outcomes and complications of flexible bronchoscopy. Methods A descriptive observational study of bronchoscopies performed at the endoscopy service of Hospital Israelita Albert Einstein . Demographic (age, gender and origin) and medical (indic...
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doaj-6e912389fec74dd4a1a5e093a1b7e0f82020-11-25T00:37:04ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-638516410.31744/einstein_journal/2018ao4380S1679-45082018000400207Indications, clinical outcomes and complications of 1,949 flexible bronchoscopiesAltair da Silva Costa JrPaulo Rogerio ScordamaglioIunis SuzukiAddy Lidvina Mejia PalominoMarcia JacomelliABSTRACT Objective To describe indications, clinical outcomes and complications of flexible bronchoscopy. Methods A descriptive observational study of bronchoscopies performed at the endoscopy service of Hospital Israelita Albert Einstein . Demographic (age, gender and origin) and medical (indications and results of endoscopy and diagnostic tests, such as biopsy collection, lavage, cytology and culture) data were analyzed. Electronic medical records with incomplete data or reporting interventional procedures were excluded. Results Over a three-year period (2013 to 2016), a total of 1,949 bronchoscopies were performed by respiratory endoscopy team and anesthesia specialists of the hospital. The mean age of patients was 57.7±21.9 years (range of 3 days to 99 years), with prevalence of males (56.4%). The procedures were mostly (86.3%) elective and 30.7% were carried out in the intensive care unit. Major indications for bronchoscopy were infection or secretion (42.4%), followed by suspected neoplasm (10.8%). Endoscopic changes were reported in 91.9% of cases, with more than one change described in approximately 6.9% of patients. Positive results were obtained via direct testing or culture in 36.3% and 53.9% of 1,399 bronchoalveolar lavages, respectively. The overall diagnostic yield (bronchoalveolar lavage and biopsy) was 72.6%. Mild adverse event rate was 7.2%. The rate of severe adverse events requiring additional intervention was 0.5% (pneumothorax, 0.4%; severe bleeding with patient death, 0.1%). Conclusion Lower airway endoscopy is critical for respiratory disease assessment, diagnosis and treatment. Flexible bronchoscopy is associated with good diagnostic yield and minimal inherent risk.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082018000400207&lng=en&tlng=enBronchoscopyCritical careRespiratory tract infection |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Altair da Silva Costa Jr Paulo Rogerio Scordamaglio Iunis Suzuki Addy Lidvina Mejia Palomino Marcia Jacomelli |
spellingShingle |
Altair da Silva Costa Jr Paulo Rogerio Scordamaglio Iunis Suzuki Addy Lidvina Mejia Palomino Marcia Jacomelli Indications, clinical outcomes and complications of 1,949 flexible bronchoscopies Einstein (São Paulo) Bronchoscopy Critical care Respiratory tract infection |
author_facet |
Altair da Silva Costa Jr Paulo Rogerio Scordamaglio Iunis Suzuki Addy Lidvina Mejia Palomino Marcia Jacomelli |
author_sort |
Altair da Silva Costa Jr |
title |
Indications, clinical outcomes and complications of 1,949 flexible bronchoscopies |
title_short |
Indications, clinical outcomes and complications of 1,949 flexible bronchoscopies |
title_full |
Indications, clinical outcomes and complications of 1,949 flexible bronchoscopies |
title_fullStr |
Indications, clinical outcomes and complications of 1,949 flexible bronchoscopies |
title_full_unstemmed |
Indications, clinical outcomes and complications of 1,949 flexible bronchoscopies |
title_sort |
indications, clinical outcomes and complications of 1,949 flexible bronchoscopies |
publisher |
Instituto Israelita de Ensino e Pesquisa Albert Einstein |
series |
Einstein (São Paulo) |
issn |
2317-6385 |
description |
ABSTRACT Objective To describe indications, clinical outcomes and complications of flexible bronchoscopy. Methods A descriptive observational study of bronchoscopies performed at the endoscopy service of Hospital Israelita Albert Einstein . Demographic (age, gender and origin) and medical (indications and results of endoscopy and diagnostic tests, such as biopsy collection, lavage, cytology and culture) data were analyzed. Electronic medical records with incomplete data or reporting interventional procedures were excluded. Results Over a three-year period (2013 to 2016), a total of 1,949 bronchoscopies were performed by respiratory endoscopy team and anesthesia specialists of the hospital. The mean age of patients was 57.7±21.9 years (range of 3 days to 99 years), with prevalence of males (56.4%). The procedures were mostly (86.3%) elective and 30.7% were carried out in the intensive care unit. Major indications for bronchoscopy were infection or secretion (42.4%), followed by suspected neoplasm (10.8%). Endoscopic changes were reported in 91.9% of cases, with more than one change described in approximately 6.9% of patients. Positive results were obtained via direct testing or culture in 36.3% and 53.9% of 1,399 bronchoalveolar lavages, respectively. The overall diagnostic yield (bronchoalveolar lavage and biopsy) was 72.6%. Mild adverse event rate was 7.2%. The rate of severe adverse events requiring additional intervention was 0.5% (pneumothorax, 0.4%; severe bleeding with patient death, 0.1%). Conclusion Lower airway endoscopy is critical for respiratory disease assessment, diagnosis and treatment. Flexible bronchoscopy is associated with good diagnostic yield and minimal inherent risk. |
topic |
Bronchoscopy Critical care Respiratory tract infection |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082018000400207&lng=en&tlng=en |
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