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Age and Ageing Advance Access originally published online on April 28, 2009
Age and Ageing 2009 38(4):396-400; doi:10.1093/ageing/afp044
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Prevalence of flexible bronchoscopic removal of foreign bodies in the advanced elderly

Michael Boyd1, Franklin Watkins2, Sonal Singh3, Edward Haponik4, Arjun Chatterjee4, John Conforti4 and Robert Chin, Jr4

1 Section of Pulmonary, Critical Care, Environmental, and Sleep Medicine, Carilion Clinic, Roanoke, VA 24014, USA
2 Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA
3 Department of Internal Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA
4 Section of Pulmonary, Critical Care, Allergy, and Immunological Diseases, Wake Forest University, Winston Salem, NC 27157, USA

Address correspondence to: M. Boyd, MD, Director of Bronchoscopy and Interventional Pulmonology, Carilion Clinic, 1906 Belleview Ave, Roanoke, VA 24014, USA. Email: mbboyd{at}carilion.com

Objectives: to define the likelihood and establish the overall safety and effectiveness of flexible bronchoscopy in the removal of foreign bodies in the advanced elderly compared to those younger.

Design: a retrospective case–control analysis.

Setting: tertiary care academic hospital.

Population: 7,089 adults (age >18 years), including 949 (15%) advanced elderly (age >75 years), who underwent flexible bronchoscopy between January 1995 and June 2007.

Measurements: in those patients with foreign body aspiration (FBA) (n = 20), a comparison of multiple clinical characteristics based on defined age groups (group 1, age <75 years and group 2, age >75 years) was performed.

Results: FBA requiring bronchoscopic removal was greater than three and a half times more likely in patients aged >75 years compared to those younger (OR 3.78, CI 1.4–10: P <0.05). Flexible bronchoscopy was 87.5% effective in the removal of foreign bodies in the advanced elderly and associated with no increase in adverse events.

Conclusion: bronchoscopic removal of foreign bodies is more likely in the advanced elderly when compared to those younger. This implies that this population may be most at risk. Flexible bronchoscopy is a safe and effective initial diagnostic and therapeutic approach in this age group.

Keywords: foreign body aspiration, elderly, advanced elderly, flexible bronchoscopy

Received 4 June 2008; accepted in revised form 11 February 2009.


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