FLEXIBLE BRONCHOSCOPY IN THE ELDERLY - 03/09/11
Résumé |
Since its introduction by Ikeda in 1970, flexible bronchoscopy has become the primary means of airway inspection and one of the most important minimally invasive procedures used in the appraisal of patients with diverse pulmonary diseases.15 Because of the high prevalence of respiratory disorders in older persons, bronchoscopy in this population is especially important. The number of people older than age 65 has escalated rapidly and is expected to increase dramatically with the aging of the “boomer” population. It has been estimated that 21% of the US population will pass this milestone by the year 2020.5, 14, 24 Moreover, by the year 2030, the number of adults aged 85 years or older (approximately 4 million) is expected to double. The historical retirement age of 65 is no longer considered to be elderly, as an aging cohort of “hardy survivors,” unburdened by severe comorbid illnesses, pursue active and fulfilling lives. During the upcoming 3 decades, such major demographic changes will influence profoundly the circumstances in which bronchoscopy is performed and its impact on patient management. With these anticipated changes, whether the indications, yield, and safety of flexible bronchoscopy vary with patient age has particular clinical relevance and merits further evaluation.
During the past 3 decades, the safety and acceptance of bronchoscopy performed in hospitalized and ambulatory patients have been well established in the general population by prospective and retrospective investigations. One limitation of these data has been that the mean age of patients was in the mid-50s or not described. Although persons older than 75 years have been included within large published experiences, to date, few series specifically have investigated the safety and efficacy of bronchoscopy in seniors.3, 6, 7, 17, 18, 19, 20, 22, 23 These predominantly have represented retrospective reports and have varied in the cut-offs of age used to define “elderly.” Interestingly, the potential effects of patient age have not been addressed in most bronchoscopy texts. In this review, the authors consider evidence regarding performance of flexible bronchoscopy in the elderly, common practices that have evolved, and areas for future clinical investigation.
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| Address reprint requests to Edward F. Haponik, MD, Division of Pulmonary and Critical Care Medicine, Johns Hopkins Hospital, 600 North Wolfe Street, Blalock 910, Baltimore, MD 21287 |
Vol 22 - N° 2
P. 301-309 - juin 2001 Retour au numéro
Article précédent
- THE FLEXIBLE BRONCHOSCOPE : A Tool for Anesthesiologists
- Andranik Ovassapian
- THE EMERGING ROLE OF FLEXIBLE BRONCHOSCOPY IN PEDIATRICS
- Robert E. Wood
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