Analysis of the Safety of Bronchoscopy in Patients Aged 80 Years and Older: A Retrospective Study

Analysis of the Safety of Bronchoscopy in Patients Aged 80 Years and Older: A Retrospective Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Analysis of the Safety of Bronchoscopy in Patients Aged 80 Years and Older: A Retrospective Study Han Keqian¹, Zhou Liang, Zhang Jianyong This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5766113/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The safety of bronchoscopy in elderly patients, particularly those aged 80 years and older, remains a concern due to age-related comorbidities. This study evaluates clinical characteristics, preoperative cardiovascular and pulmonary indicators, and bronchoscopy-related complications across different age groups. Methods A retrospective study of 349 patients undergoing bronchoscopy was conducted. Patients were categorized into three groups: Young (< 65 years, n = 120), Elderly (65–79 years, n = 120), and Oldest Elderly (≥ 80 years, n = 109). Demographics, cardiovascular and pulmonary indicators, and procedural complications were analyzed. Results The oldest elderly group exhibited significantly higher rates of preoperative cardiovascular conditions, including arrhythmia (76.15%), hypertension (36.70%), and elevated D-dimer levels (54.13%) (all p < 0.01). Pulmonary function was more impaired, with increased rates of emphysema (27.52%) and respiratory failure (25.69%) (all p < 0.01). However, intraoperative complications such as mild bleeding (93.58%) and hypoxia (6.42%) were not significantly different across groups. Post-procedural recovery was favorable in 96.33% of patients. Conclusions Bronchoscopy is generally safe in patients aged ≥ 80 years when appropriate precautions are taken. Careful preoperative assessment is critical in minimizing procedural risks. Trial registration Clinical trial number not applicable. Bronchoscopy oldest-old patients safety Introduction Bronchoscopy (Flexible Bronchofiberscope, FB) is a fundamental endoscopic procedure in respiratory medicine, widely used for diagnostic and therapeutic purposes[ 1 ]. The procedure involves inserting a flexible tube into the tracheobronchial tree to directly visualize the airways, obtain samples for cytology, biopsy, and lavage, and perform interventions such as drug administration and lesion resection[ 2 ]. The integration of advanced technologies, including endobronchial ultrasound (EBUS) and electromagnetic navigation bronchoscopy (ENB), has significantly enhanced its diagnostic accuracy, particularly in lung cancer and infectious diseases[ 3 ][ 4 ]. Over the past decade, bronchoscopy has rapidly evolved into a key tool for diagnosing and managing pulmonary diseases[ 5 ]. especially in minimally invasive lung cancer staging and management[ 6 ], with potential benefits for improving patient outcomes[ 7 ]. With the increasing incidence of respiratory diseases, such as lung cancer and tuberculosis, the demand for bronchoscopy in elderly patients is growing[ 8 ][ 9 ]. In particular, an emerging patient group—the oldest elderly (defined as individuals aged ≥ 80 years by the American Geriatrics Society and the World Health Organization)—requires increasing medical attention[ 10 ]. The global population of individuals over 80 years old is projected to nearly quadruple within the next 30 years, rising from 126.5 million to 446.6 million[ 11 ]. Given the high prevalence of chronic respiratory diseases in this demographic, the need for bronchoscopy is expected to rise proportionally. However, elderly patients often present with multiple comorbidities, raising concerns about the safety and feasibility of bronchoscopy in this population. Existing studies indicate that bronchoscopy is generally safe in elderly patients[ 12 ][ 13 ][ 14 ]. However, most investigations have primarily focused on younger populations, with limited research dedicated to patients over 80 years old[ 15 ][ 16 ][ 17 ][ 18 ]. Since advanced age is often associated with an increased risk of cardiovascular and pulmonary complications, it remains unclear whether the oldest elderly patients experience similar safety outcomes as younger individuals. Therefore, this study aims to compare the safety and effectiveness of bronchoscopy across three age groups (< 65 years, 65–79 years, and ≥ 80 years). The primary objectives include assessing the incidence of complications, diagnostic yield, and clinical outcomes in patients aged 80 years and older. By employing statistical analyses and inter-group comparisons, this study seeks to provide evidence-based validation of the clinical feasibility of bronchoscopy in the oldest elderly population. Methods Study Design This study is a retrospective cohort analysis designed to evaluate the safety and efficacy of bronchoscopy in patients across different age groups, with a particular focus on individuals aged ≥ 80 years. Patient data were collected from the Affiliated Hospital of Zunyi Medical University, with eligible cases spanning from September 2017 to February 2024. A total of 349 patients who underwent bronchoscopy were included and categorized into three age groups: Young group (< 65 years, n = 120), Elderly group (65–79 years, n = 120), and Oldest elderly group (≥ 80 years, n = 109). The primary objective was to compare complication rates, diagnostic accuracy, and clinical management outcomes across these three age groups. Categorical variables (e.g., gender, smoking history) were analyzed using chi-square tests, while continuous variables (e.g., age, blood pressure) were assessed using analysis of variance (ANOVA). Additionally, multivariate regression analysis was conducted to identify potential factors influencing complication rates and diagnostic yield in the oldest elderly group. Study Population A total of 349 patients were included, with an initial sample size of 120 per group to ensure statistical robustness. However, due to exclusions, the final oldest elderly group comprised 109 cases. Inclusion criteria were as follows: (1) patients aged 18 years and older, (2) those who completed bronchoscopy with complete clinical data available, and (3) those who provided informed consent signed by the patient or their legal guardian. Patients were excluded if they canceled bronchoscopy due to clinical instability or non-compliance, if they had severe comorbidities preventing tolerance of the procedure, or if their medical records were incomplete or lacked follow-up data. Data Collection General patient information was recorded, including gender, age, department of admission, smoking history, and presence of severe conditions. Severe conditions were defined as cases in which a “critical condition” medical order was issued during hospitalization, often due to respiratory failure, acute respiratory distress syndrome (ARDS), severe pneumonia, chronic obstructive pulmonary disease (COPD) exacerbation, pulmonary embolism, pneumothorax, multiple organ dysfunction syndrome (MODS), or other life-threatening conditions. The use of antithrombotic agents and steroids was also documented. Pre-examination data included baseline vital signs such as blood pressure, blood gas analysis (including oxygen partial pressure, carbon dioxide partial pressure, and oxygen saturation), laboratory results such as electrolyte levels, fibrinogen, and D-dimer, as well as pulmonary function test results. Underlying diseases, including hypertension, coronary artery disease, COPD, and tuberculosis, were also recorded. Preoperative evaluations involved detailed records of chest computed tomography (CT) findings, including inflammation, fibrosis, nodules, and pleural effusion. Electrocardiogram (ECG) abnormalities such as arrhythmia, right bundle branch block, and atrial premature beats were assessed. Additional pre-bronchoscopy interventions, including thoracentesis, thoracoscopy, and endotracheal intubation, were noted. The study also documented pre-bronchoscopy clinical diagnoses such as lung masses, tuberculosis, pneumonia, emphysema, bronchiectasis, and atelectasis, along with major symptoms including cough, hemoptysis, and dyspnea. All patients received local anesthesia with topical 1% lidocaine applied to the nasal cavity, oropharynx, and airway mucosa. In addition, a subset of patients underwent painless bronchoscopy, which was defined as local anesthesia combined with intravenous sedation and analgesia. Sedation was administered via intravenous midazolam (1–3 mg) and fentanyl (25–50 µg), with continuous cardiorespiratory monitoring throughout the procedure, consistent with standard practice for moderate sedation. The choice of anesthesia method was based on patient condition, tolerance, and clinical judgment. The bronchoscopy procedure was analyzed in detail, including the sampling techniques used, such as electronic bronchoscopy, bronchoalveolar lavage (BAL), brushing, transbronchial biopsy, endobronchial ultrasound (EBUS), and transbronchial needle aspiration (TBNA). The anatomical locations of sample collection were recorded, including the upper, middle, and lower lobes, or instances where no sample was collected. Postoperative recovery and complications were carefully documented, with intraoperative events such as bleeding, hypoxia, and abnormal mucosal findings noted. Postoperative monitoring included duration of observation, overall recovery, and any significant adverse events. Statistical Analysis Categorical variables such as gender, smoking history, hypertension, and underlying diseases were expressed as frequencies and percentages (values are presented as n (%)), with comparisons performed using the chi-square test or Fisher’s exact test when necessary. Continuous variables, including age and blood pressure, were tested for normality. Normally distributed variables were expressed as mean ± standard deviation (x̅±s) and analyzed using one-way ANOVA. Non-normally distributed continuous variables, such as pulmonary function test parameters (FEV1, FEV1/FVC ratio, DLCO), were assessed using the Kruskal-Wallis test. All statistical analyses were conducted using SPSS 26.0 software, and a two-tailed P-value < 0.05 was considered statistically significant. Results A total of 349 patients who underwent bronchoscopy were included in the study, with 120 patients in the young group (< 65 years), 120 patients in the elderly group (65–79 years), and 109 patients in the oldest elderly group (≥ 80 years). There was no significant difference in gender distribution among the three groups (P = 0.806), with the proportion of male patients ranging from 56.67–63.30%. As expected, there was a statistically significant difference in age among the three groups (P < 0.01). The smoking history rate was highest in the elderly group (55.83%) and lowest in the oldest elderly group (41.28%), but the difference among the three groups was not statistically significant (P = 0.259). The incidence of severe conditions requiring critical care was higher in the elderly group (21.67%) than in the oldest elderly (21.10%) and young (10.00%) groups, but this trend did not reach statistical significance (P = 0.053). The use of antithrombotic agents increased significantly with age, from 1.66% in the young group to 7.50% in the elderly group and 20.18% in the oldest elderly group (P < 0.01). In contrast, steroid use was comparable across the three groups, with no significant difference observed (P = 0.263). These findings are summarized in Table 1 . Table 1 Patient Demographics [n (%)] Young Group (n = 120) Elderly Group (n = 120) Oldest Elderly Group (n = 109) P-value Gender (Male) 68(56.67) 73(60.83) 69(63.30) 0.806 Age (years, x̅±s) 48.68 ± 12.91 70.83 ± 3.92 82.32 ± 2.38 < 0.01 Smoking History 64(53.33) 67(55.83) 45(41.28) 0.259 Severe Condition a 12(10.00) 26(21.67) 23(21.10) 0.053 Use of Antithrombotic b Agents 2(1.66) 9(7.50) 22(20.18) < 0.01 Use of Steroids 17(14.17) 25(20.83) 14(12.84) 0.263 a Severe condition was defined as cases in which a “critical condition” medical order was issued during hospitalization, often due to respiratory failure, acute respiratory distress syndrome (ARDS), severe pneumonia, chronic obstructive pulmonary disease (COPD) exacerbation, pulmonary embolism, pneumothorax, multiple organ dysfunction syndrome (MODS), or other life-threatening conditions. It may also refer to patients whose post-assessment status was deemed poor and required Critical care. b Use of antithrombotic agents includes both anticoagulants and antiplatelet agents, which were combined into one category. Significant differences were observed in cardiovascular preoperative indicators among the three groups (Table 2 ). Baseline systolic and diastolic blood pressures were highest in the oldest elderly group (130.02 ± 17.84 mmHg and 75.02 ± 11.39 mmHg, respectively), with statistically significant differences across all groups (P < 0.01).In blood sample abnormalities, fibrinogen (43.12%) and D-dimer (54.13%) levels were significantly elevated in the oldest elderly group compared to the young (17.50%, 25.00%) and elderly groups (15.00%, 23.33%) (P < 0.01). However, potassium level abnormalities showed no significant difference (P = 0.124). Among underlying diseases, arrhythmia prevalence surged in the oldest elderly group (76.15%), in contrast to its near absence in the younger groups (P < 0.01). Hypertension, hypokalemia, and cerebral infarction also increased significantly with age (P < 0.01), whereas coronary artery disease showed no significant difference (P = 0.069). For ECG abnormalities, atrial premature beats (P < 0.01) and right bundle branch block (P = 0.044) were notably higher in the oldest elderly group, while sinus tachycardia, ventricular premature beats, and abnormal Q waves did not show statistically significant differences. Table 2 Cardiovascular Preoperative Indicators [n (%)] Indicator Young Group (n = 120) Elderly Group (n = 120) Oldest Elderly Group (n = 109) P-value Blood Pressure (mmHg, x̄±s) Baseline Systolic Pressure 122.14 ± 15.54 127.95 ± 18.61 130.02 ± 17.84 < 0.01 Baseline Diastolic Pressure 77.59 ± 11.64 78.15 ± 12.47 75.02 ± 11.39 < 0.01 Abnormal Blood Sample Data Electrolytes (Potassium) a 14 (11.67) 25 (20.83) 24 (22.02) 0.124 Fibrinogen a 21 (17.50) 18 (15.00) 47 (43.12) < 0.01 D-Dimer a 30 (25.00) 28 (23.33) 59 (54.13) < 0.01 Underlying Diseases Arrhythmia b 18 (15.00) 29 (24.17) 83 (76.15) < 0.01 Hypertension 15 (12.50) 44 (36.67) 40 (36.70) < 0.01 Hypokalemia 2 (1.67) 10 (8.33) 24 (22.02) < 0.01 Cerebral Infarction 2 (1.67) 10 (8.33) 15 (13.76) < 0.01 Coronary Artery Disease 3 (2.50) 10 (8.33) 11 (10.09) 0.069 Electrocardiogram (ECG) Abnormalities Sinus Tachycardia 10 (8.33) 15 (12.50) 18 (16.51) 0.211 Atrial Premature Beats 2 (1.67) 5 (4.17) 14 (12.84) < 0.01 Right Bundle Branch Block 2 (1.67) 6 (5.00) 10 (9.17) 0.044 Ventricular Premature Beats 3 (2.50) 4 (3.33) 8 (7.34) 0.173 Abnormal Q Wave 3 (2.50) 3 (2.50) 8 (7.34) 0.112 b Electrolytes (Potassium), Fibrinogen and D-dimer levels were considered abnormal based on hospital-specific laboratory reference ranges. a Arrhythmia includes any documented rhythm disturbances during hospitalization. Significant differences in pulmonary preoperative indicators were observed among the three age groups (Table 3 ). Chest CT findings revealed that fibrosis (P = 0.011), emphysema (P < 0.01), interstitial lung disease (P < 0.01), pleural effusion (P < 0.01), and tuberculosis (P 0.05). Pulmonary function declined significantly with age. The oldest elderly group had the lowest FVC (55.05%, P < 0.01) and the highest proportion of FEV1 < 50% predicted (18.35%, P < 0.01). The proportion of patients with a normal FEV1/FVC ratio decreased with age, while those with reduced ratios increased, particularly in the oldest elderly group (42.20%, P < 0.01). DLCO was also significantly lower in the oldest elderly group (P = 0.016), though DLCO < 50% did not differ significantly (P = 0.508).COPD, respiratory failure, and tuberculosis were significantly more common in the oldest elderly group (all P < 0.01), while hypoxemia showed no significant difference (P = 0.443). Antibiotic use during hospitalization was comparable among groups (P = 0.655), and no significant differences were found in pre-bronchoscopy procedures such as thoracentesis, central venous catheterization, and endotracheal intubation (all P > 0.05). Table 3 Pulmonary Preoperative Indicators [n (%)] Indicator Young Group (n = 120) Elderly Group (n = 120) Oldest Elderly Group (n = 109) P-value Chest CT Findings Inflammation 32 (26.67) 38 (31.67) 48 (44.04) 0.069 Fibrosis 18 (15.00) 26 (21.67) 37 (33.94) 0.011 Emphysema 7 (5.83) 21 (17.50) 30 (27.52) < 0.01 Malignant Tumor (Suspected/Confirmed) 26 (21.67) 33 (27.50) 32 (29.36) 0.487 Pulmonary Nodule 27 (22.50) 25 (20.83) 23 (21.10) 0.957 Interstitial Lung Disease 6 (5.00) 8 (6.67) 21 (19.27) < 0.01 Pleural Effusion 7 (5.83) 6 (5.00) 18 (16.51) < 0.01 Tuberculosis (Suspected/Confirmed) 12 (10.00) 10 (8.33) 24 (22.02) < 0.01 Chronic Bronchitis 1 (0.83) 8 (6.67) 11 (10.09) 0.012 Bronchiectasis 7 (5.83) 5 (4.17) 10 (9.17) 0.311 Bronchial Stenosis 3 (2.50) 13 (10.83) 9 (8.26) 0.048 Pulmonary Function Tests a FVC 97 (80.83) 78 (65.00) 60 (55.05) < 0.01 < 50% of Predicted Value 3 (2.50) 17 (14.17) 20 (18.35) < 0.01 FEV1 (Normal) 98 (81.67) 85 (70.83) 72 (66.06) < 0.01 Moderate to Severe Decrease 2 (1.67) 10 (8.33) 8 (7.34) 0.036 FEV1/FVC Ratio (Normal) 84 (70.00) 57 (47.50) 34 (31.19) < 0.01 Reduced 16 (13.33) 38 (31.67) 46 (42.20) < 0.01 DLCO (Normal) 75 (62.50) 67 (55.83) 54 (49.54) 0.016 DLCO < 50% of Predicted Value 19 (15.83) 22 (18.33) 23 (21.10) 0.508 Underlying Diseases COPD 6 (5.00) 0 (0.00) 53 (48.62) < 0.01 Respiratory Failure 1 (0.83) 2 (1.67) 28 (25.69) < 0.01 Tuberculosis 4 (3.33) 3 (2.50) 21 (19.27) < 0.01 Hypoxemia 9 (7.50) 13 (10.83) 14 (12.84) 0.443 Antibiotic Use During Hospitalization Yes 106 (88.33) 105 (87.50) 92 (84.40) 0.655 No 14 (11.67) 15 (12.50) 17 (15.60) 0.655 Average Duration (hours, x̄±s) 263.69 245.91 239.83 < 0.01 Pre-Bronchoscopy Procedures b Total 14 (11.67) 12 (10.00) 21 (19.27) 0.130 Thoracentesis/Lumbar Puncture 6 (5.00) 5 (4.17) 9 (8.26) 0.399 Central Venous Catheterization 2 (1.67) 0 (0.00) 3 (2.75) 0.213 Thoracoscopy 5 (4.17) 7 (5.83) 2 (1.83) 0.319 Endotracheal Intubation 1 (0.83) 0 (0.00) 2 (1.83) 0.327 CT Computed Tomography, FVC Forced Vital Capacity, FEV1 Forced Expiratory Volume in 1 second, DLCO Diffusing Capacity of the Lungs for Carbon Monoxide, COPD Chronic Obstructive Pulmonary Disease a Pulmonary function tests were performed when feasible . However, some patients were unable to complete the tests due to severe respiratory impairment or frailty. Missing values were not imputed, and the total number of patients tested for each parameter is reported in the table. b The total number of pre-bronchoscopy procedures includes additional minor procedures that were not individually reported in the table. Significant differences in pre-bronchoscopy clinical diagnoses and symptoms were observed across the three age groups (Table 4 ). The prevalence of tuberculosis (suspected/confirmed) was highest in the oldest elderly group (26.61%), compared to the elderly (3.33%) and young groups (2.50%) (P < 0.01). Pulmonary mass lesions were most frequently diagnosed in the elderly group (53.33%), followed by the young group (40.83%), and were least common in the oldest elderly group (18.35%) (P < 0.01). No significant differences were observed in the prevalence of pneumonia (P = 0.067), atelectasis (P = 0.199), or bronchiectasis (P = 0.099). Emphysema was detected exclusively in the oldest elderly group (5.50%, P < 0.01). Regarding pre-bronchoscopy symptoms, cough and sputum production were the most frequently reported symptoms in all groups, with the highest prevalence observed in the oldest elderly group (75.23%) (P = 0.031). The proportion of patients presenting with definitive pulmonary masses was highest in the elderly group (47.50%) and lowest in the oldest elderly group (22.94%) (P < 0.01). No significant differences were found in the incidence of hemoptysis (P = 0.065) or foreign body aspiration (P = 0.327). Dyspnea was significantly more frequent in the oldest elderly group (5.50%) compared to the young (1.67%) and elderly groups (0.00%) (P = 0.020). Regarding anesthesia, the use of painless bronchoscopy significantly declined with age. The proportion of patients undergoing painless bronchoscopy was 59.2% in the < 65 years group, 43.3% in the 65–79 years group, and 16.5% in the ≥ 80 years group (P < 0.01). The remaining patients in each group received bronchoscopy under local anesthesia alone. The use of electronic bronchoscopy increased with age, with 78.90% of the oldest elderly group undergoing the procedure, compared to 42.50% in the elderly group and 39.17% in the young group (P < 0.01). The use of brushing was similar across the three groups, with no significant differences observed (P = 0.212). In contrast, endobronchial biopsy (P = 0.036), endobronchial ultrasound (EBUS) (P = 0.038), and endoscopic bronchial lesion resection (P < 0.01) were significantly less common in the oldest elderly group. No significant differences were found in the use of bronchoalveolar lavage (BAL) (P = 0.562) or transbronchial needle aspiration (TBNA) (P = 0.158). The distribution of brushing sites was also comparable among the three groups, with no significant differences in the selection of the upper lobe (P = 0.440), middle lobe (P = 0.101), or lower lobe (P = 0.848) for sampling. Similarly, the proportion of patients who did not undergo brushing did not differ significantly between groups (P = 0.613). Table 4 Pre-Bronchoscopy Clinical Diagnosis, Symptoms, Anesthesia Method, Sampling Techniques, and Brushing Sites [n (%)] Item Young Group (n = 120) Elderly Group (n = 120) Oldest Elderly Group (n = 109) P-value Pre-Bronchoscopy Clinical Diagnosis a Tuberculosis (Suspected/Confirmed) 3 (2.50) 4 (3.33) 29 (26.61) < 0.01 Pulmonary Mass Lesion 49 (40.83) 64 (53.33) 20 (18.35) < 0.01 Pneumonia 36 (30.00) 23 (19.17) 18 (16.51) 0.067 Emphysema 0 (0.00) 0 (0.00) 6 (5.50) < 0.01 Atelectasis 5 (4.17) 2 (1.67) 7 (6.42) 0.199 Bronchiectasis 7 (5.83) 1 (0.83) 6 (5.50) 0.099 Foreign Body in Bronchus 0 (0.00) 1 (0.83) 1 (0.92) 0.590 Pre-Bronchoscopy Symptoms Cough/Sputum Production 67 (55.83) 59 (49.17) 82 (75.23) 0.031 Definitive Pulmonary Mass 45 (37.50) 57 (47.50) 25 (22.94) < 0.01 Hemoptysis 5 (4.17) 2 (1.67) 9 (8.26) 0.065 Dyspnea 2 (1.67) 0 (0.00) 6 (5.50) 0.020 Foreign Body in Bronchus 0 (0.00) 1 (0.83) 2 (1.83) 0.327 Anesthesia Method Painless Bronchoscopy 71 (59.17) 52 (43.33) 18 (16.51) < 0.01 Sampling Techniques Electronic Bronchoscopy 47 (39.17) 51 (42.50) 86 (78.90) < 0.01 Brushing 83 (69.17) 91 (75.83) 62 (56.88) 0.212 BAL 10 (8.33) 15 (12.50) 10 (9.17) 0.562 Endobronchial Biopsy 19 (15.83) 26 (21.67) 9 (8.26) 0.036 EBUS 17 (14.17) 24 (20.00) 8 (7.34) 0.038 TBNA 10 (8.33) 3 (2.50) 7 (6.42) 0.158 Endoscopic Bronchial Lesion Resection 10 (8.33) 2 (1.67) 1 (0.92) < 0.01 Brushing Sites Upper Lobe (Left/Right) 46 (38.33) 35 (29.17) 40 (36.70) 0.440 Middle Lobe 14 (11.67) 26 (21.67) 14 (12.84) 0.101 Lower Lobe (Left/Right) 44 (36.67) 39 (32.50) 39 (35.78) 0.848 No Brushing Performed 16 (13.33) 20 (16.67) 13 (11.93) 0.613 BAL Bronchoalveolar Lavage, EBUS Endobronchial Ultrasound, TBNA Transbronchial Needle Aspiration a Pre-Bronchoscopy Clinical Diagnosis refers to the preliminary diagnosis established before the procedure. b Pre-Bronchoscopy Symptoms indicate the primary manifestations observed in patients before undergoing bronchoscopy. “Painless bronchoscopy” refers to local anesthesia combined with intravenous sedation and analgesia. Patients not receiving painless bronchoscopy were treated with local anesthesia only. Significant differences were observed in bronchoscopic diagnoses among the three age groups (Table 5 ). The proportion of patients with no abnormal findings on endoscopic examination was highest in the young group (30.83%) and decreased in the elderly (20.00%) and oldest elderly (10.09%) groups (P < 0.01). The prevalence of inflammation was slightly higher in the oldest elderly group (43.12%) than in the elderly (37.50%) and young (28.33%) groups, though the difference was not statistically significant (P = 0.169). There were no significant differences in the detection rates of suspected malignant tumors (P = 0.385), neoplasms (P = 0.325), or bronchial stenosis/obstruction (P = 0.263) among the three groups. Pathological diagnoses showed similar trends. The proportion of patients with no abnormal pathological findings ranged from 21.67% in the elderly group to 33.94% in the oldest elderly group, but the difference was not significant (P = 0.210). The prevalence of inflammation, including chronic bronchitis and infectious pneumonia, was comparable across groups (P = 0.959). Confirmed malignant tumors were detected at similar rates, with the highest proportion in the elderly group (41.67%) and lower rates in the young (32.50%) and oldest elderly groups (33.03%) (P = 0.416). Non-small cell lung cancer was observed at comparable frequencies in all groups (P = 0.273). However, small cell lung cancer was more frequently diagnosed in the elderly group (6.67%) than in the young (0.83%) and oldest elderly groups (1.83%) (P = 0.025). Intraoperative complications were primarily mild. Mild bleeding occurred in most patients, with no significant differences between groups (P = 0.928). However, hypoxia was significantly more frequent in the oldest elderly group (6.42%) than in the elderly (0.83%) and young (0.83%) groups (P = 0.011). The frequency of anesthetic allergy (P = 0.385), absence of intraoperative complications (P = 0.072), and severe complications such as severe bleeding or hypoxia (P = 0.333) did not differ significantly among groups. Postoperative recovery was favorable in all groups. The majority of patients had stable vital signs without significant discomfort, with rates exceeding 96% in all groups (P = 0.959). Mild postoperative discomfort, such as blood-tinged sputum and fatigue, was slightly more common in the oldest elderly group (3.67%), though the difference was not statistically significant (P = 0.052). Procedure duration was significantly longer in the oldest elderly group (24.95 ± 9.81 minutes) compared to the elderly (22.83 ± 14.84 minutes) and young (19.85 ± 12.95 minutes) groups (P < 0.01). Postoperative observation time was significantly shorter in the elderly (16.35 ± 9.09 minutes) and oldest elderly (16.95 ± 10.70 minutes) groups than in the young group (18.68 ± 10.98 minutes) (P < 0.01). Table 5 Bronchoscopic Diagnosis, Intraoperative Complications, and Postoperative Recovery [n (%)] Item Young Group (n = 120) Elderly Group (n = 120) Oldest Elderly Group (n = 109) P-value Endoscopic Diagnosis a No Abnormal Findings 37 (30.83) 24 (20.00) 11 (10.09) < 0.01 Inflammation 34 (28.33) 45 (37.50) 47 (43.12) 0.169 Malignant Tumor (Suspected) 20 (16.67) 23 (19.17) 13 (11.93) 0.385 Neoplasm 8 (6.67) 7 (5.83) 12 (11.01) 0.325 Bronchial Stenosis/Obstruction 9 (7.50) 14 (11.67) 16 (14.68) 0.263 Pathological Diagnosis No Abnormal Findings 34 (28.33) 26 (21.67) 37 (33.94) 0.210 Inflammation (Including Chronic Bronchitis, Infectious Pneumonia) 36 (30.00) 37 (30.83) 35 (32.11) 0.959 Malignant Tumor (Confirmed) 39 (32.50) 50 (41.67) 36 (33.03) 0.416 Non-Small Cell Lung Cancer (Including Squamous Cell Carcinoma/Adenocarcinoma) 33 (27.50) 40 (33.33) 26 (23.85) 0.273 Small Cell Lung Cancer 1 (0.83) 8 (6.67) 2 (1.83) 0.025 Intraoperative Complications Mild Bleeding 117 (97.50) 118 (98.33) 102 (93.58) 0.928 Hypoxia 1 (0.83) 1 (0.83) 7 (6.42) 0.011 Anesthetic Allergy 1 (0.83) 0 (0.00) 0 (0.00) 0.385 No Intraoperative Complications 1 (0.83) 1 (0.83) 5 (4.59) 0.072 Severe Complications (Severe Bleeding, Severe Hypoxia, etc.) b 0 (0.00) 0 (0.00) 1 (0.92) 0.333 Postoperative Recovery Stable Vital Signs, No Significant Discomfort 119 (99.17) 120 (100.00) 105 (96.33) 0.959 Mild Postoperative Discomfort (e.g., Blood-Tinged Sputum, Fatigue) 1 (0.83) 0 (0.00) 4 (3.67) 0.052 Procedure Duration (Minutes, x̅±s) 19.85 ± 12.95 22.83 ± 14.84 24.95 ± 9.81 < 0.01 Postoperative Observation Time (Minutes, x̅±s) c 18.68 ± 10.98 16.35 ± 9.09 16.95 ± 10.70 < 0.01 a Endoscopic diagnoses were based on real-time bronchoscopic findings, while pathological diagnoses were confirmed through histological or cytological examination. b Severe complications were defined as events requiring immediate intervention, such as significant bleeding requiring additional hemostatic measures or severe hypoxia necessitating oxygen therapy. c Postoperative observation time refers to the duration of immediate post-procedure monitoring before patient discharge or transfer from the procedure unit. Discussion Flexible bronchoscopy is a widely used tool for both diagnosis and therapy in respiratory medicine, and its safety in elderly patients has been well established[ 19 ]. However, most prior studies have focused on patients aged < 80 years, with limited research specifically evaluating procedural risks in the oldest elderly population[ 15 ]. Our study provides evidence that bronchoscopy remains feasible and safe in patients aged ≥ 80 years despite their increased burden of cardiovascular and pulmonary comorbidities. Similar to previous studies reporting a relatively low incidence of complications in elderly patients undergoing bronchoscopy examination[ 20 ], our findings suggest that severe adverse events remain rare in the oldest elderly group. While some reports indicate increased risks of hypoxia and hemodynamic instability due to reduced cardiopulmonary reserve in elderly patients[ 21 ][ 22 ], we observed no significant difference in major complications across age groups. The low complication rate may be due to preoperative optimization, procedural adaptations, and technical advancements in bronchoscopy such as high-flow nasal oxygenation and real-time monitoring, which have improved patient safety[ 23 ]. Transient hypoxia was more frequent in the oldest elderly group, though it was effectively managed with appropriate oxygen supplementation. Importantly, these episodes did not lead to severe post-procedural complications, reinforcing the effectiveness of intraoperative oxygen supplementation strategies. Despite these pulmonary concerns, intraoperative bleeding remained comparable across groups, likely due to procedural modifications and careful anticoagulation management strategies that have improved safety in this population. A notable finding in our study was the significantly higher prevalence of cardiovascular comorbidities, including arrhythmia (76.15%) and elevated D-dimer levels (54.13%), in the oldest elderly group. Prior studies have also reported increased cardiovascular risk factors in this population, which may predispose them to perioperative complications[ 24 ]. However, we found that careful preoperative assessment and intraoperative hemodynamic monitoring effectively mitigated these risks. This aligns with previous research emphasizing the importance of individualized risk stratification in elderly patients undergoing bronchoscopy[ 25 ]. The use of antithrombotic agents was also more frequent in this group, yet without a significant increase in bleeding complications, highlighting the importance of tailored perioperative management to balance thromboembolic risks and procedural safety. In contrast, corticosteroid use was less common in the oldest elderly group, possibly due to concerns about adverse effects such as immunosuppression and metabolic disturbances. Given the potential role of steroids in managing airway inflammation, future research should explore optimal strategies for balancing their benefits and risks in elderly patients undergoing bronchoscopy. In addition, our study analyzed anesthesia methods in the oldest elderly group, revealing that while most patients underwent local anesthesia, a subset (18 patients) received painless bronchoscopy. Perioperative risk was assessed using the ASA (American Society of Anesthesiologists) classification system, with 14 patients classified as ASA grade 2 and four as grade 3 (including one as grade 3E). This assessment enabled targeted intraoperative monitoring and postoperative care. Among those who received sedation, the mean intraoperative oxygen saturation was 99.4%, although 38.89% required non-invasive ventilation for transient hypoxia, which was effectively managed. Six patients experienced transient hypotension requiring vasopressor support, but all recovered with stable vital signs. Notably, despite previous reports of increased postoperative fever, CRP elevation, and nausea following painless bronchoscopy[ 26 ], no such complications occurred in our cohort. These findings suggest that, with individualized monitoring and perioperative care, sedation can be used safely in selected elderly patients. When analyzing the entire cohort, no significant difference in complication rates was found between patients who underwent local versus painless bronchoscopy. The observed decline in the use of painless bronchoscopy with increasing age likely reflects concerns regarding sedation-related risks in older adults with comorbidities. Although sedation improves procedural tolerance and patient comfort, it may pose higher risks of respiratory depression, hypotension, or delayed recovery. However, our findings demonstrated that, when appropriately managed, sedation did not result in serious adverse events even in patients aged ≥ 80 years. This highlights the importance of careful patient selection and tailored anesthesia planning in geriatric populations. In addition to anesthesia considerations, the type of bronchoscopic techniques used may also influence procedural safety. Furthermore, many of the bronchoscopic procedures performed in our cohort, such as brushing and bronchoalveolar lavage (BAL), are considered minimally invasive and are generally associated with low complication rates. These techniques are widely used for diagnostic purposes and typically do not result in significant adverse events when performed under standard protocols. Their frequent application in our study population, including among the oldest elderly group, may partially explain the overall low incidence of serious intraoperative and postoperative complications. This reinforces the safety profile of flexible bronchoscopy when using evidence-based, minimally invasive techniques, even in high-risk age groups. Age-related pulmonary function decline has been well documented in the literature[ 27 ]. Our study confirms this trend, with the oldest elderly group exhibiting significantly lower FVC and FEV1 values, as well as higher rates of emphysema (27.52%) and interstitial lung disease (19.27%). This is consistent with reports indicating that lung function deterioration accelerates with age, increasing the risk of respiratory complications during bronchoscopy[ 28 ]. Furthermore, reduced diffusing capacity for carbon monoxide (DLCO) was more prevalent in the oldest elderly group, indicating impaired gas exchange efficiency. The high prevalence of chronic respiratory conditions such as COPD and respiratory failure in this group underscores the need for cautious procedural planning and appropriate respiratory support. Interestingly, while some studies suggest that reduced pulmonary reserve increases the likelihood of hypoxemia during bronchoscopy[ 29 ], our data showed no significant difference in oxygen desaturation events across age groups, except for a slightly higher rate of transient hypoxia (6.42%) in the oldest elderly group. This suggests that with adequate oxygen supplementation and procedural modifications, bronchoscopy remains a viable option even in patients with compromised respiratory function. The use of bronchoscopy for diagnosing malignancy, infection, and interstitial lung disease is well-established[ 30 ][ 31 ]. In our study, the oldest elderly group had a significantly lower rate of transbronchial biopsy and endobronchial ultrasound (EBUS) use compared to younger patients, likely due to concerns regarding procedural tolerance. Instead, a greater proportion of the oldest elderly patients underwent electronic bronchoscopy (78.90%), reflecting a preference for less invasive techniques. This trend is in line with recent recommendations advocating for the selective use of biopsy-based procedures in frail elderly patients to minimize procedural risk, as age has been identified as a risk factor in the occurrence of complications during or after bronchoscopic lung biopsy.[ 32 ][ 33 ].Moreover, procedure duration was slightly longer in the oldest elderly group, suggesting that greater caution was exercised during the examination. This could reflect more careful maneuvering of the bronchoscope, additional time for oxygenation, or the need for a slower approach due to patient frailty. However, postoperative recovery times remained comparable across groups, suggesting that procedural tolerance in elderly patients can be maintained with appropriate perioperative management. Given the variability in frailty levels, further studies should explore whether individual frailty indices predict recovery outcomes more accurately. Our study also found that tuberculosis was significantly more prevalent in the oldest elderly group (26.61%), a finding consistent with epidemiological data showing increased TB susceptibility in aging populations due to immune senescence[ 34 ]. Given that TB symptoms in older adults may be less pronounced or atypical, the role of bronchoscopy in providing a definitive diagnosis is particularly important in this population. This underscores the importance of bronchoscopy in diagnosing pulmonary infections in older adults, particularly in endemic regions. This study has several limitations. First, as a retrospective analysis, it is subject to selection bias, and certain variables, such as operator experience and procedural modifications, were not standardized. Second, pulmonary function tests, including DLCO, were not available for all patients, limiting our ability to fully assess baseline respiratory function. Additionally, while we stratified patients by age, intra-group variability in frailty and functional status was not accounted for, which may influence procedural tolerance and recovery. Future studies should investigate the impact of frailty indices on procedural outcomes. Such research will be essential to refining procedural guidelines for bronchoscopy in the growing population of the oldest old. Conclusions Our study demonstrates that despite the high prevalence of cardiovascular and pulmonary comorbidities in patients aged 80 years and older, bronchoscopy remains a safe and feasible diagnostic tool when proper preoperative assessment and perioperative management are implemented. The incidence of hypoxia and bleeding was low, and post-procedural recovery was favorable. Future research should focus on refining risk assessment models for elderly patients and exploring AI-assisted bronchoscopy and non-invasive diagnostic techniques to enhance diagnostic efficiency while reducing unnecessary invasive procedures. Future research should focus on refining risk assessment models for elderly patients and evaluating the role of non-invasive diagnostic techniques to improve procedural safety while minimizing unnecessary interventions. Abbreviations FB: Flexible Bronchofiberscope CT: Computed Tomography Scan COPD: Chronic Obstructive Pulmonary Disease FVC: Forced Vital Capacity FEV1: Forced Expiratory Volume in One Second DLCO: Diffusing Capacity of the Lungs for Carbon Monoxide BAL: Bronchoalveolar Lavage EBUS: Endobronchial Ultrasound TBNA: Transbronchial Needle Aspiration ASA: American Society of Anesthesiologists Declarations Authors’ Contributions K. H.: Data curation, Formal analysis, Writing - Original draft. L. Z.: Writing - Reviewing and Editing. J. Z.: Writing - Validation, Reviewing and Editing, Supervision. All authors reviewed the manuscript and approved the final version for publication. Funding This study was supported by the Guizhou Maotai Hospital Research and Talent Development Fund for the year 2024 (No. MTyk2024-19). Data Availability Statement The data that support the findings of this study are available from the corresponding author, Zhang Jianyong, upon reasonable request. Due to privacy considerations, detailed data are not publicly accessible. Ethics Approval and Consent to Participate: The study was approved by the institutional review board of the Affiliated Hospital of Zunyi Medical University and conducted in accordance with the Declaration of Helsinki. Informed consent was waived due to the retrospective nature of the study. Consent for Publication Not applicable. Competing Interests The authors declare no competing interests. Author Details 1 Department of Respiratory Medicine, Affiliated Hospital of Zunyi Medical University, Guizhou, China. References PharmD JAM, MD FS, Bronchoscopy. A Medication Guide to Internal Medicine Tests and Procedures2022. Fu Y, Ding W. Diagnosis and Interventional Therapy by Bronchoscopy. 2017. Sun X, Su Y, Li S, Tian Y, Zhao L. [Diagnostic Value and Safety of Electromagnetic Navigation Bronchoscopy in Peripheral Pulmonary Lesions: A Meta-analysis]. Zhongguo Fei Ai Za Zhi. 2023;26(2):119–34. Chen JY, Yang H, Lin XD, Yang H, Wen J, Liu QW, et al. Diagnostic yield using electromagnetic navigation bronchoscopy for peripheral pulmonary nodules < 2 cm. Ther Adv Respir Dis. 2024;18:17534666241249150. Pápai-Székely Z, Grmela G, Sárosi V. Novel diagnostic processes and challenges in bronchoscopy. Pathol Oncol Res. 2024;30:1611774. Biciuşcă V, Popescu IAS, Traşcă DM, Olteanu M, Stan IS, Durand P, et al. Diagnosis of lung cancer by flexible fiberoptic bronchoscopy: a descriptive study. Rom J Morphol Embryol. 2022;63(2):369–81. Hu Q, Wu J, Wang C, Liang W, Wang Y, Zheng Y, et al. Outcomes and Risk Factor Analysis of Plastic Bronchitis Among 321 Children with Influenza Pneumonia After Bronchoscopy Examination. Infect Drug Resist. 2023;16:4001–11. Casaluce F, Sgambato A, Maione P, Spagnuolo A, Gridelli C. Lung cancer, elderly and immune checkpoint inhibitors. J Thorac Dis. 2018;10(Suppl 13):S1474–81. Olmo-Fontánez AM, Turner J. Tuberculosis in an Aging World. Pathogens. 2022;11(10). Escourrou E, Laurent S, Leroux J, Oustric S, Gardette V. The shift from old age to very old age: an analysis of the perception of aging among older people. BMC Prim Care. 2022;23(1):3. Emile E, Sarah L, Jacques L, Stéphane O, Virginie G. The shift from old age to very old age: an analysis of the perception of aging among older people. BMC Prim Care. 2022;23. Zentaro S, Issei O, Takanori I, Takuma I, Osamu K, Kohei F et al. Safety and Efficacy of Flexible Bronchoscopy in Elderly Patients: A Retrospective Comparative Study. Open Respir Arch. 2023;5. Masamichi M, Kei M, Naoki F, Hirotaka K, Hiroki N, Hiroshi H et al. Flexible bronchoscopy for lung cancer diagnosis in patients aged ≥ 85 years. Geriatr Gerontol Int. 2021;22. Cameron WM, Andrew JS, Ellis RE, Michael JM. The Safety and Utility of Fiberoptic Bronchoscopy in the Very Elderly. J Bronchol Interv Pulmonol. 2018;25. Qanash S, Hakami O, Al-Husayni F, Gari A. Flexible Fiberoptic Bronchoscopy: Indications, Diagnostic Yield and Complications. Cureus. 2020;12(10):e11122. Aslıhan Gürün K, Miraç Ö, Umut D, Duygu E, Serhat E, Fatma Ç et al. IS FLEXIBLE BRONCHOSCOPY A SAFE PROCEDURE FOR CRITICAL CARE PATIENTS WITH RESPIRATORY FAILURE? Acta Clin Croat. 2024;62. Anil S, Neeraj G, Anuj K, Ganpat J, Geetha RM. Utility and safety of flexible fiberoptic bronchoscopy in mechanically ventilated children in pediatric intensive care unit. Pediatr Pulmonol. 2022;57. Congcong L, Yanyan L, Faguang J, Liyan B. The bleeding risk and safety of multiple treatments by bronchoscopy in patients with central airway stenosis. Expert Rev Respir Med. 2023;17. Clérigo JC V, Monteiro P, Gonçalves JR. C. Bárbara Interventional Pulmonology Unit, Centro Hospitalar Lisboa Norte, Lisbon, Portugal. Indications and complications of flexible bronchoscopy in very elderly patients. Chest. 2017. Saito Z, Oi I, Ito T, Imakita T, Kanai O, Fujita K, et al. Safety of flexible bronchoscopy and clinical course for elderly patients with suspected primary lung cancer. Thorac Cancer. 2024;15(8):614–21. Tesauro M, Mauriello A, Rovella V, Annicchiarico-Petruzzelli M, Cardillo C, Melino G, et al. Arterial ageing: from endothelial dysfunction to vascular calcification. J Intern Med. 2017;281(5):471–82. Thiboutot J, Brown RH. Breathing Life into Pulmonary Physiology: How Age and Body Weight Impair Oxygenation. Anesthesiology. 2019;131(1):7–9. Kumagai K, Tsuruoka H, Morikawa K, Handa H, Mineshita M. Pre-treatment bronchoscopic evaluation in a case of relapsing polychondrits. BMC Pulm Med. 2023;23(1):108. Chotisukarat H, Akavipat P, Suchartwatnachai P, Sookplung P, Eiamcharoenwit J. Incidence and Risk Factors for Perioperative Cardiovascular Complications in Spine Surgery. F1000Res. 2022;11:15. Scandrett KG, Zuckerbraun BS, Peitzman AB. Operative risk stratification in the older adult. Surg Clin North Am. 2015;95(1):149–72. Lv ZH, Yuan N. Construction of a Risk Prediction Model for Fever After Painless Bronchoscopy. Med Sci Monit. 2020;26:e924911. Zhang G, Qu Y, Wu Z, Liu W, Luo H, Chen R, et al. Association between low lung function and the increased risk of age-related macular degeneration: A population-based prospective cohort study. J Glob Health. 2024;14:04102. Tran D, Rajwani K, Berlin DA. Pulmonary effects of aging. Curr Opin Anaesthesiol. 2018;31(1):19–23. Rumbak M, Clum SR. Anticipating, Preventing, and Treating Complications in Patients With Limited Pulmonary Reserve. J Bronchol Interv Pulmonol. 2017;24(2):96–7. Park D. Advanced Bronchoscopic Diagnostic Techniques in Lung Cancer. Tuberc Respir Dis (Seoul). 2024;87(3):282–91. Röder M, Ng A, Conway Morris A. Bronchoscopic Diagnosis of Severe Respiratory Infections. J Clin Med. 2024;13:19. Mondoni M, Rinaldo RF, Carlucci P, Terraneo S, Saderi L, Centanni S, et al. Bronchoscopic sampling techniques in the era of technological bronchoscopy. Pulmonology. 2022;28(6):461–71. Pocienė I, Gauronskaitė R, Galkauskas D, Mainelis A, Gruslys V, Danila E. Age as a Risk Factor in the Occurrence of Complications during or after Bronchoscopic Lung Biopsy. Geriatr (Basel). 2022;7(2). Jiang H, Chen X, Lv J, Dai B, Liu Q, Ding X, et al. Prospective cohort study on tuberculosis incidence and risk factors in the elderly population of eastern China. Heliyon. 2024;10(3):e24507. 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The procedure involves inserting a flexible tube into the tracheobronchial tree to directly visualize the airways, obtain samples for cytology, biopsy, and lavage, and perform interventions such as drug administration and lesion resection[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The integration of advanced technologies, including endobronchial ultrasound (EBUS) and electromagnetic navigation bronchoscopy (ENB), has significantly enhanced its diagnostic accuracy, particularly in lung cancer and infectious diseases[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e][\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Over the past decade, bronchoscopy has rapidly evolved into a key tool for diagnosing and managing pulmonary diseases[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. especially in minimally invasive lung cancer staging and management[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], with potential benefits for improving patient outcomes[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWith the increasing incidence of respiratory diseases, such as lung cancer and tuberculosis, the demand for bronchoscopy in elderly patients is growing[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e][\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In particular, an emerging patient group\u0026mdash;the oldest elderly (defined as individuals aged\u0026thinsp;\u0026ge;\u0026thinsp;80 years by the American Geriatrics Society and the World Health Organization)\u0026mdash;requires increasing medical attention[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The global population of individuals over 80 years old is projected to nearly quadruple within the next 30 years, rising from 126.5\u0026nbsp;million to 446.6 million[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Given the high prevalence of chronic respiratory diseases in this demographic, the need for bronchoscopy is expected to rise proportionally. However, elderly patients often present with multiple comorbidities, raising concerns about the safety and feasibility of bronchoscopy in this population.\u003c/p\u003e \u003cp\u003eExisting studies indicate that bronchoscopy is generally safe in elderly patients[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e][\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e][\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. However, most investigations have primarily focused on younger populations, with limited research dedicated to patients over 80 years old[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e][\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e][\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e][\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Since advanced age is often associated with an increased risk of cardiovascular and pulmonary complications, it remains unclear whether the oldest elderly patients experience similar safety outcomes as younger individuals. Therefore, this study aims to compare the safety and effectiveness of bronchoscopy across three age groups (\u0026lt;\u0026thinsp;65 years, 65\u0026ndash;79 years, and \u0026ge;\u0026thinsp;80 years). The primary objectives include assessing the incidence of complications, diagnostic yield, and clinical outcomes in patients aged 80 years and older. By employing statistical analyses and inter-group comparisons, this study seeks to provide evidence-based validation of the clinical feasibility of bronchoscopy in the oldest elderly population.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis study is a retrospective cohort analysis designed to evaluate the safety and efficacy of bronchoscopy in patients across different age groups, with a particular focus on individuals aged\u0026thinsp;\u0026ge;\u0026thinsp;80 years. Patient data were collected from the Affiliated Hospital of Zunyi Medical University, with eligible cases spanning from September 2017 to February 2024. A total of 349 patients who underwent bronchoscopy were included and categorized into three age groups: Young group (\u0026lt;\u0026thinsp;65 years, n\u0026thinsp;=\u0026thinsp;120), Elderly group (65\u0026ndash;79 years, n\u0026thinsp;=\u0026thinsp;120), and Oldest elderly group (\u0026ge;\u0026thinsp;80 years, n\u0026thinsp;=\u0026thinsp;109). The primary objective was to compare complication rates, diagnostic accuracy, and clinical management outcomes across these three age groups. Categorical variables (e.g., gender, smoking history) were analyzed using chi-square tests, while continuous variables (e.g., age, blood pressure) were assessed using analysis of variance (ANOVA). Additionally, multivariate regression analysis was conducted to identify potential factors influencing complication rates and diagnostic yield in the oldest elderly group.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Population\u003c/h3\u003e\n\u003cp\u003eA total of 349 patients were included, with an initial sample size of 120 per group to ensure statistical robustness. However, due to exclusions, the final oldest elderly group comprised 109 cases. Inclusion criteria were as follows: (1) patients aged 18 years and older, (2) those who completed bronchoscopy with complete clinical data available, and (3) those who provided informed consent signed by the patient or their legal guardian. Patients were excluded if they canceled bronchoscopy due to clinical instability or non-compliance, if they had severe comorbidities preventing tolerance of the procedure, or if their medical records were incomplete or lacked follow-up data.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eGeneral patient information was recorded, including gender, age, department of admission, smoking history, and presence of severe conditions. Severe conditions were defined as cases in which a \u0026ldquo;critical condition\u0026rdquo; medical order was issued during hospitalization, often due to respiratory failure, acute respiratory distress syndrome (ARDS), severe pneumonia, chronic obstructive pulmonary disease (COPD) exacerbation, pulmonary embolism, pneumothorax, multiple organ dysfunction syndrome (MODS), or other life-threatening conditions. The use of antithrombotic agents and steroids was also documented.\u003c/p\u003e \u003cp\u003ePre-examination data included baseline vital signs such as blood pressure, blood gas analysis (including oxygen partial pressure, carbon dioxide partial pressure, and oxygen saturation), laboratory results such as electrolyte levels, fibrinogen, and D-dimer, as well as pulmonary function test results. Underlying diseases, including hypertension, coronary artery disease, COPD, and tuberculosis, were also recorded.\u003c/p\u003e \u003cp\u003ePreoperative evaluations involved detailed records of chest computed tomography (CT) findings, including inflammation, fibrosis, nodules, and pleural effusion. Electrocardiogram (ECG) abnormalities such as arrhythmia, right bundle branch block, and atrial premature beats were assessed. Additional pre-bronchoscopy interventions, including thoracentesis, thoracoscopy, and endotracheal intubation, were noted. The study also documented pre-bronchoscopy clinical diagnoses such as lung masses, tuberculosis, pneumonia, emphysema, bronchiectasis, and atelectasis, along with major symptoms including cough, hemoptysis, and dyspnea.\u003c/p\u003e \u003cp\u003e All patients received local anesthesia with topical 1% lidocaine applied to the nasal cavity, oropharynx, and airway mucosa. In addition, a subset of patients underwent painless bronchoscopy, which was defined as local anesthesia combined with intravenous sedation and analgesia. Sedation was administered via intravenous midazolam (1\u0026ndash;3 mg) and fentanyl (25\u0026ndash;50 \u0026micro;g), with continuous cardiorespiratory monitoring throughout the procedure, consistent with standard practice for moderate sedation. The choice of anesthesia method was based on patient condition, tolerance, and clinical judgment.\u003c/p\u003e \u003cp\u003eThe bronchoscopy procedure was analyzed in detail, including the sampling techniques used, such as electronic bronchoscopy, bronchoalveolar lavage (BAL), brushing, transbronchial biopsy, endobronchial ultrasound (EBUS), and transbronchial needle aspiration (TBNA). The anatomical locations of sample collection were recorded, including the upper, middle, and lower lobes, or instances where no sample was collected. Postoperative recovery and complications were carefully documented, with intraoperative events such as bleeding, hypoxia, and abnormal mucosal findings noted. Postoperative monitoring included duration of observation, overall recovery, and any significant adverse events.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eCategorical variables such as gender, smoking history, hypertension, and underlying diseases were expressed as frequencies and percentages (values are presented as n (%)), with comparisons performed using the chi-square test or Fisher\u0026rsquo;s exact test when necessary. Continuous variables, including age and blood pressure, were tested for normality. Normally distributed variables were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x̅\u0026plusmn;s) and analyzed using one-way ANOVA. Non-normally distributed continuous variables, such as pulmonary function test parameters (FEV1, FEV1/FVC ratio, DLCO), were assessed using the Kruskal-Wallis test. All statistical analyses were conducted using SPSS 26.0 software, and a two-tailed P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 349 patients who underwent bronchoscopy were included in the study, with 120 patients in the young group (\u0026lt;\u0026thinsp;65 years), 120 patients in the elderly group (65\u0026ndash;79 years), and 109 patients in the oldest elderly group (\u0026ge;\u0026thinsp;80 years). There was no significant difference in gender distribution among the three groups (P\u0026thinsp;=\u0026thinsp;0.806), with the proportion of male patients ranging from 56.67\u0026ndash;63.30%. As expected, there was a statistically significant difference in age among the three groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The smoking history rate was highest in the elderly group (55.83%) and lowest in the oldest elderly group (41.28%), but the difference among the three groups was not statistically significant (P\u0026thinsp;=\u0026thinsp;0.259). The incidence of severe conditions requiring critical care was higher in the elderly group (21.67%) than in the oldest elderly (21.10%) and young (10.00%) groups, but this trend did not reach statistical significance (P\u0026thinsp;=\u0026thinsp;0.053). The use of antithrombotic agents increased significantly with age, from 1.66% in the young group to 7.50% in the elderly group and 20.18% in the oldest elderly group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). In contrast, steroid use was comparable across the three groups, with no significant difference observed (P\u0026thinsp;=\u0026thinsp;0.263). These findings are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatient Demographics [n (%)]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYoung Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eElderly Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOldest Elderly Group (n\u0026thinsp;=\u0026thinsp;109)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender (Male)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68(56.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73(60.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69(63.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.806\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (years, x̅\u0026plusmn;s)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48.68\u0026thinsp;\u0026plusmn;\u0026thinsp;12.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70.83\u0026thinsp;\u0026plusmn;\u0026thinsp;3.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e82.32\u0026thinsp;\u0026plusmn;\u0026thinsp;2.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking History\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64(53.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67(55.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45(41.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.259\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSevere Condition\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12(10.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26(21.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23(21.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUse of Antithrombotic\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e \u003cb\u003eAgents\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(1.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9(7.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22(20.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUse of Steroids\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17(14.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25(20.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14(12.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.263\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e Severe condition was defined as cases in which a \u0026ldquo;critical condition\u0026rdquo; medical order was issued during hospitalization, often due to respiratory failure, acute respiratory distress syndrome (ARDS), severe pneumonia, chronic obstructive pulmonary disease (COPD) exacerbation, pulmonary embolism, pneumothorax, multiple organ dysfunction syndrome (MODS), or other life-threatening conditions. It may also refer to patients whose post-assessment status was deemed poor and required Critical care.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e Use of antithrombotic agents includes both anticoagulants and antiplatelet agents, which were combined into one category.\u003c/p\u003e \u003cp\u003eSignificant differences were observed in cardiovascular preoperative indicators among the three groups (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Baseline systolic and diastolic blood pressures were highest in the oldest elderly group (130.02\u0026thinsp;\u0026plusmn;\u0026thinsp;17.84 mmHg and 75.02\u0026thinsp;\u0026plusmn;\u0026thinsp;11.39 mmHg, respectively), with statistically significant differences across all groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01).In blood sample abnormalities, fibrinogen (43.12%) and D-dimer (54.13%) levels were significantly elevated in the oldest elderly group compared to the young (17.50%, 25.00%) and elderly groups (15.00%, 23.33%) (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). However, potassium level abnormalities showed no significant difference (P\u0026thinsp;=\u0026thinsp;0.124). Among underlying diseases, arrhythmia prevalence surged in the oldest elderly group (76.15%), in contrast to its near absence in the younger groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Hypertension, hypokalemia, and cerebral infarction also increased significantly with age (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), whereas coronary artery disease showed no significant difference (P\u0026thinsp;=\u0026thinsp;0.069). For ECG abnormalities, atrial premature beats (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and right bundle branch block (P\u0026thinsp;=\u0026thinsp;0.044) were notably higher in the oldest elderly group, while sinus tachycardia, ventricular premature beats, and abnormal Q waves did not show statistically significant differences.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCardiovascular Preoperative Indicators [n (%)]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYoung Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eElderly Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOldest Elderly Group (n\u0026thinsp;=\u0026thinsp;109)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlood Pressure (mmHg, x̄\u0026plusmn;s)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline Systolic Pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122.14\u0026thinsp;\u0026plusmn;\u0026thinsp;15.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127.95\u0026thinsp;\u0026plusmn;\u0026thinsp;18.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e130.02\u0026thinsp;\u0026plusmn;\u0026thinsp;17.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline Diastolic Pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77.59\u0026thinsp;\u0026plusmn;\u0026thinsp;11.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78.15\u0026thinsp;\u0026plusmn;\u0026thinsp;12.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.02\u0026thinsp;\u0026plusmn;\u0026thinsp;11.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAbnormal Blood Sample Data\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElectrolytes (Potassium)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (11.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (20.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (22.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.124\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFibrinogen\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (17.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (15.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47 (43.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eD-Dimer\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (23.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59 (54.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUnderlying Diseases\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArrhythmia\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (15.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (24.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83 (76.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (12.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (36.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40 (36.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypokalemia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (22.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebral Infarction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (13.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoronary Artery Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (10.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.069\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElectrocardiogram (ECG) Abnormalities\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSinus Tachycardia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (12.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (16.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.211\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAtrial Premature Beats\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (4.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (12.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRight Bundle Branch Block\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (5.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (9.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVentricular Premature Beats\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (3.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (7.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.173\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbnormal Q Wave\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (7.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.112\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e Electrolytes (Potassium), Fibrinogen and D-dimer levels were considered abnormal based on hospital-specific laboratory reference ranges.\u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e Arrhythmia includes any documented rhythm disturbances during hospitalization.\u003c/p\u003e \u003cp\u003eSignificant differences in pulmonary preoperative indicators were observed among the three age groups (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Chest CT findings revealed that fibrosis (P\u0026thinsp;=\u0026thinsp;0.011), emphysema (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), interstitial lung disease (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), pleural effusion (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and tuberculosis (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01) were significantly more prevalent in the oldest elderly group. Malignant tumors, pulmonary nodules, and bronchiectasis showed no significant difference among groups (all P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Pulmonary function declined significantly with age. The oldest elderly group had the lowest FVC (55.05%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and the highest proportion of FEV1\u0026thinsp;\u0026lt;\u0026thinsp;50% predicted (18.35%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The proportion of patients with a normal FEV1/FVC ratio decreased with age, while those with reduced ratios increased, particularly in the oldest elderly group (42.20%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). DLCO was also significantly lower in the oldest elderly group (P\u0026thinsp;=\u0026thinsp;0.016), though DLCO\u0026thinsp;\u0026lt;\u0026thinsp;50% did not differ significantly (P\u0026thinsp;=\u0026thinsp;0.508).COPD, respiratory failure, and tuberculosis were significantly more common in the oldest elderly group (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), while hypoxemia showed no significant difference (P\u0026thinsp;=\u0026thinsp;0.443). Antibiotic use during hospitalization was comparable among groups (P\u0026thinsp;=\u0026thinsp;0.655), and no significant differences were found in pre-bronchoscopy procedures such as thoracentesis, central venous catheterization, and endotracheal intubation (all P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePulmonary Preoperative Indicators [n (%)]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYoung Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eElderly Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOldest Elderly Group (n\u0026thinsp;=\u0026thinsp;109)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChest CT Findings\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInflammation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (26.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (31.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48 (44.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.069\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFibrosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (15.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (21.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37 (33.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmphysema\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (5.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (17.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30 (27.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignant Tumor (Suspected/Confirmed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26 (21.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (27.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32 (29.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.487\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePulmonary Nodule\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27 (22.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (20.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23 (21.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.957\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInterstitial Lung Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (5.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (6.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21 (19.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePleural Effusion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (5.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (5.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (16.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTuberculosis (Suspected/Confirmed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (10.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24 (22.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic Bronchitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (6.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (10.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBronchiectasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (5.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (4.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (9.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.311\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBronchial Stenosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (10.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (8.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePulmonary Function Tests\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFVC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e97 (80.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78 (65.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60 (55.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;50% of Predicted Value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (14.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (18.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFEV1 (Normal)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e98 (81.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85 (70.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e72 (66.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate to Severe Decrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (7.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.036\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFEV1/FVC Ratio (Normal)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e84 (70.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57 (47.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34 (31.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReduced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (13.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (31.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46 (42.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDLCO (Normal)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e75 (62.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67 (55.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e54 (49.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDLCO\u0026thinsp;\u0026lt;\u0026thinsp;50% of Predicted Value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (15.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (18.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23 (21.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUnderlying Diseases\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOPD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (5.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53 (48.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory Failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (25.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTuberculosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (3.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21 (19.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypoxemia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (7.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (10.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14 (12.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.443\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAntibiotic Use During Hospitalization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e106 (88.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e105 (87.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e92 (84.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (11.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (12.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17 (15.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAverage Duration (hours, x̄\u0026plusmn;s)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e263.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e245.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e239.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePre-Bronchoscopy Procedures\u003c/b\u003e\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (11.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (10.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21 (19.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.130\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThoracentesis/Lumbar Puncture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (5.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (4.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (8.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.399\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral Venous Catheterization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (2.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThoracoscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (4.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (5.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.319\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndotracheal Intubation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.327\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eCT\u003c/em\u003e Computed Tomography, \u003cem\u003eFVC\u003c/em\u003e Forced Vital Capacity, \u003cem\u003eFEV1\u003c/em\u003e Forced Expiratory Volume in 1 second, \u003cem\u003eDLCO\u003c/em\u003e Diffusing Capacity of the Lungs for Carbon Monoxide, \u003cem\u003eCOPD\u003c/em\u003e Chronic Obstructive Pulmonary Disease\u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e Pulmonary function tests were performed when \u003cem\u003efeasible\u003c/em\u003e. However, some patients were unable to complete the tests due to severe respiratory impairment or frailty. Missing values were not imputed, and the total number of patients tested for each parameter is reported in the table.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e The total number of pre-bronchoscopy procedures includes additional minor procedures that were not individually reported in the table.\u003c/p\u003e \u003cp\u003eSignificant differences in pre-bronchoscopy clinical diagnoses and symptoms were observed across the three age groups (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The prevalence of tuberculosis (suspected/confirmed) was highest in the oldest elderly group (26.61%), compared to the elderly (3.33%) and young groups (2.50%) (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Pulmonary mass lesions were most frequently diagnosed in the elderly group (53.33%), followed by the young group (40.83%), and were least common in the oldest elderly group (18.35%) (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). No significant differences were observed in the prevalence of pneumonia (P\u0026thinsp;=\u0026thinsp;0.067), atelectasis (P\u0026thinsp;=\u0026thinsp;0.199), or bronchiectasis (P\u0026thinsp;=\u0026thinsp;0.099). Emphysema was detected exclusively in the oldest elderly group (5.50%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Regarding pre-bronchoscopy symptoms, cough and sputum production were the most frequently reported symptoms in all groups, with the highest prevalence observed in the oldest elderly group (75.23%) (P\u0026thinsp;=\u0026thinsp;0.031). The proportion of patients presenting with definitive pulmonary masses was highest in the elderly group (47.50%) and lowest in the oldest elderly group (22.94%) (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). No significant differences were found in the incidence of hemoptysis (P\u0026thinsp;=\u0026thinsp;0.065) or foreign body aspiration (P\u0026thinsp;=\u0026thinsp;0.327). Dyspnea was significantly more frequent in the oldest elderly group (5.50%) compared to the young (1.67%) and elderly groups (0.00%) (P\u0026thinsp;=\u0026thinsp;0.020). Regarding anesthesia, the use of painless bronchoscopy significantly declined with age. The proportion of patients undergoing painless bronchoscopy was 59.2% in the \u0026lt;\u0026thinsp;65 years group, 43.3% in the 65\u0026ndash;79 years group, and 16.5% in the \u0026ge;\u0026thinsp;80 years group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The remaining patients in each group received bronchoscopy under local anesthesia alone. The use of electronic bronchoscopy increased with age, with 78.90% of the oldest elderly group undergoing the procedure, compared to 42.50% in the elderly group and 39.17% in the young group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The use of brushing was similar across the three groups, with no significant differences observed (P\u0026thinsp;=\u0026thinsp;0.212). In contrast, endobronchial biopsy (P\u0026thinsp;=\u0026thinsp;0.036), endobronchial ultrasound (EBUS) (P\u0026thinsp;=\u0026thinsp;0.038), and endoscopic bronchial lesion resection (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01) were significantly less common in the oldest elderly group. No significant differences were found in the use of bronchoalveolar lavage (BAL) (P\u0026thinsp;=\u0026thinsp;0.562) or transbronchial needle aspiration (TBNA) (P\u0026thinsp;=\u0026thinsp;0.158). The distribution of brushing sites was also comparable among the three groups, with no significant differences in the selection of the upper lobe (P\u0026thinsp;=\u0026thinsp;0.440), middle lobe (P\u0026thinsp;=\u0026thinsp;0.101), or lower lobe (P\u0026thinsp;=\u0026thinsp;0.848) for sampling. Similarly, the proportion of patients who did not undergo brushing did not differ significantly between groups (P\u0026thinsp;=\u0026thinsp;0.613).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePre-Bronchoscopy Clinical Diagnosis, Symptoms, Anesthesia Method, Sampling Techniques, and Brushing Sites [n (%)]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYoung Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eElderly Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOldest Elderly Group (n\u0026thinsp;=\u0026thinsp;109)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePre-Bronchoscopy Clinical Diagnosis\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTuberculosis (Suspected/Confirmed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (3.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29 (26.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePulmonary Mass Lesion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49 (40.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64 (53.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (18.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePneumonia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (30.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (19.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (16.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmphysema\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (5.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAtelectasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (4.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (6.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBronchiectasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (5.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (5.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.099\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign Body in Bronchus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.590\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePre-Bronchoscopy Symptoms\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCough/Sputum Production\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67 (55.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59 (49.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e82 (75.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDefinitive Pulmonary Mass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45 (37.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57 (47.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25 (22.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemoptysis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (4.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (8.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDyspnea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (5.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign Body in Bronchus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.327\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAnesthesia Method\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless Bronchoscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71 (59.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52 (43.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (16.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSampling Techniques\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElectronic Bronchoscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (39.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51 (42.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86 (78.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrushing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83 (69.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91 (75.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62 (56.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.212\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBAL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (12.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (9.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.562\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndobronchial Biopsy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (15.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (21.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (8.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.036\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 (14.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24 (20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (7.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (6.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.158\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndoscopic Bronchial Lesion Resection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBrushing Sites\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper Lobe (Left/Right)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46 (38.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (29.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40 (36.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.440\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle Lobe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (11.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (21.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14 (12.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower Lobe (Left/Right)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44 (36.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39 (32.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39 (35.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.848\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Brushing Performed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (13.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (16.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (11.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.613\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003cp\u003e\u003cem\u003eBAL\u003c/em\u003e Bronchoalveolar Lavage, \u003cem\u003eEBUS\u003c/em\u003e Endobronchial Ultrasound, \u003cem\u003eTBNA\u003c/em\u003e Transbronchial Needle Aspiration\u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e Pre-Bronchoscopy Clinical Diagnosis refers to the preliminary diagnosis established before the procedure.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e Pre-Bronchoscopy Symptoms indicate the primary manifestations observed in patients before undergoing bronchoscopy.\u003c/p\u003e \u003cp\u003e\u0026ldquo;Painless bronchoscopy\u0026rdquo; refers to local anesthesia combined with intravenous sedation and analgesia. Patients not receiving painless bronchoscopy were treated with local anesthesia only.\u003c/p\u003e \u003cp\u003eSignificant differences were observed in bronchoscopic diagnoses among the three age groups (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). The proportion of patients with no abnormal findings on endoscopic examination was highest in the young group (30.83%) and decreased in the elderly (20.00%) and oldest elderly (10.09%) groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The prevalence of inflammation was slightly higher in the oldest elderly group (43.12%) than in the elderly (37.50%) and young (28.33%) groups, though the difference was not statistically significant (P\u0026thinsp;=\u0026thinsp;0.169). There were no significant differences in the detection rates of suspected malignant tumors (P\u0026thinsp;=\u0026thinsp;0.385), neoplasms (P\u0026thinsp;=\u0026thinsp;0.325), or bronchial stenosis/obstruction (P\u0026thinsp;=\u0026thinsp;0.263) among the three groups. Pathological diagnoses showed similar trends. The proportion of patients with no abnormal pathological findings ranged from 21.67% in the elderly group to 33.94% in the oldest elderly group, but the difference was not significant (P\u0026thinsp;=\u0026thinsp;0.210). The prevalence of inflammation, including chronic bronchitis and infectious pneumonia, was comparable across groups (P\u0026thinsp;=\u0026thinsp;0.959). Confirmed malignant tumors were detected at similar rates, with the highest proportion in the elderly group (41.67%) and lower rates in the young (32.50%) and oldest elderly groups (33.03%) (P\u0026thinsp;=\u0026thinsp;0.416). Non-small cell lung cancer was observed at comparable frequencies in all groups (P\u0026thinsp;=\u0026thinsp;0.273). However, small cell lung cancer was more frequently diagnosed in the elderly group (6.67%) than in the young (0.83%) and oldest elderly groups (1.83%) (P\u0026thinsp;=\u0026thinsp;0.025). Intraoperative complications were primarily mild. Mild bleeding occurred in most patients, with no significant differences between groups (P\u0026thinsp;=\u0026thinsp;0.928). However, hypoxia was significantly more frequent in the oldest elderly group (6.42%) than in the elderly (0.83%) and young (0.83%) groups (P\u0026thinsp;=\u0026thinsp;0.011). The frequency of anesthetic allergy (P\u0026thinsp;=\u0026thinsp;0.385), absence of intraoperative complications (P\u0026thinsp;=\u0026thinsp;0.072), and severe complications such as severe bleeding or hypoxia (P\u0026thinsp;=\u0026thinsp;0.333) did not differ significantly among groups. Postoperative recovery was favorable in all groups. The majority of patients had stable vital signs without significant discomfort, with rates exceeding 96% in all groups (P\u0026thinsp;=\u0026thinsp;0.959). Mild postoperative discomfort, such as blood-tinged sputum and fatigue, was slightly more common in the oldest elderly group (3.67%), though the difference was not statistically significant (P\u0026thinsp;=\u0026thinsp;0.052). Procedure duration was significantly longer in the oldest elderly group (24.95\u0026thinsp;\u0026plusmn;\u0026thinsp;9.81 minutes) compared to the elderly (22.83\u0026thinsp;\u0026plusmn;\u0026thinsp;14.84 minutes) and young (19.85\u0026thinsp;\u0026plusmn;\u0026thinsp;12.95 minutes) groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Postoperative observation time was significantly shorter in the elderly (16.35\u0026thinsp;\u0026plusmn;\u0026thinsp;9.09 minutes) and oldest elderly (16.95\u0026thinsp;\u0026plusmn;\u0026thinsp;10.70 minutes) groups than in the young group (18.68\u0026thinsp;\u0026plusmn;\u0026thinsp;10.98 minutes) (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBronchoscopic Diagnosis, Intraoperative Complications, and Postoperative Recovery [n (%)]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYoung Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eElderly Group (n\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOldest Elderly Group (n\u0026thinsp;=\u0026thinsp;109)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndoscopic Diagnosis\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Abnormal Findings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (30.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24 (20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (10.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInflammation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34 (28.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (37.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47 (43.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.169\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignant Tumor (Suspected)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (16.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (19.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (11.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.385\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (6.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (5.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (11.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.325\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBronchial Stenosis/Obstruction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (7.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (11.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (14.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.263\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePathological Diagnosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Abnormal Findings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34 (28.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (21.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37 (33.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.210\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInflammation (Including Chronic Bronchitis, Infectious Pneumonia)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (30.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37 (30.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35 (32.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.959\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignant Tumor (Confirmed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39 (32.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50 (41.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36 (33.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.416\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-Small Cell Lung Cancer (Including Squamous Cell Carcinoma/Adenocarcinoma)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33 (27.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (33.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26 (23.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.273\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmall Cell Lung Cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (6.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIntraoperative Complications\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild Bleeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e117 (97.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118 (98.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e102 (93.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.928\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypoxia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (6.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnesthetic Allergy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.385\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Intraoperative Complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5 (4.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere Complications (Severe Bleeding, Severe Hypoxia, etc.)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePostoperative Recovery\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStable Vital Signs, No Significant Discomfort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e119 (99.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120 (100.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e105 (96.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.959\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild Postoperative Discomfort (e.g., Blood-Tinged Sputum, Fatigue)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (3.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProcedure Duration (Minutes, x̅\u0026plusmn;s)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19.85\u0026thinsp;\u0026plusmn;\u0026thinsp;12.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.83\u0026thinsp;\u0026plusmn;\u0026thinsp;14.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.95\u0026thinsp;\u0026plusmn;\u0026thinsp;9.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePostoperative Observation Time (Minutes, x̅\u0026plusmn;s)\u003c/b\u003e\u003csup\u003e\u003cb\u003ec\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.68\u0026thinsp;\u0026plusmn;\u0026thinsp;10.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.35\u0026thinsp;\u0026plusmn;\u0026thinsp;9.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.95\u0026thinsp;\u0026plusmn;\u0026thinsp;10.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e Endoscopic diagnoses were based on real-time bronchoscopic findings, while pathological diagnoses were confirmed through histological or cytological examination.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e Severe complications were defined as events requiring immediate intervention, such as significant bleeding requiring additional hemostatic measures or severe hypoxia necessitating oxygen therapy.\u003c/p\u003e \u003cp\u003e \u003csup\u003ec\u003c/sup\u003e Postoperative observation time refers to the duration of immediate post-procedure monitoring before patient discharge or transfer from the procedure unit.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eFlexible bronchoscopy is a widely used tool for both diagnosis and therapy in respiratory medicine, and its safety in elderly patients has been well established[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. However, most prior studies have focused on patients aged\u0026thinsp;\u0026lt;\u0026thinsp;80 years, with limited research specifically evaluating procedural risks in the oldest elderly population[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Our study provides evidence that bronchoscopy remains feasible and safe in patients aged\u0026thinsp;\u0026ge;\u0026thinsp;80 years despite their increased burden of cardiovascular and pulmonary comorbidities.\u003c/p\u003e \u003cp\u003eSimilar to previous studies reporting a relatively low incidence of complications in elderly patients undergoing bronchoscopy examination[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], our findings suggest that severe adverse events remain rare in the oldest elderly group. While some reports indicate increased risks of hypoxia and hemodynamic instability due to reduced cardiopulmonary reserve in elderly patients[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e][\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], we observed no significant difference in major complications across age groups. The low complication rate may be due to preoperative optimization, procedural adaptations, and technical advancements in bronchoscopy such as high-flow nasal oxygenation and real-time monitoring, which have improved patient safety[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Transient hypoxia was more frequent in the oldest elderly group, though it was effectively managed with appropriate oxygen supplementation. Importantly, these episodes did not lead to severe post-procedural complications, reinforcing the effectiveness of intraoperative oxygen supplementation strategies. Despite these pulmonary concerns, intraoperative bleeding remained comparable across groups, likely due to procedural modifications and careful anticoagulation management strategies that have improved safety in this population.\u003c/p\u003e \u003cp\u003eA notable finding in our study was the significantly higher prevalence of cardiovascular comorbidities, including arrhythmia (76.15%) and elevated D-dimer levels (54.13%), in the oldest elderly group. Prior studies have also reported increased cardiovascular risk factors in this population, which may predispose them to perioperative complications[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. However, we found that careful preoperative assessment and intraoperative hemodynamic monitoring effectively mitigated these risks. This aligns with previous research emphasizing the importance of individualized risk stratification in elderly patients undergoing bronchoscopy[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The use of antithrombotic agents was also more frequent in this group, yet without a significant increase in bleeding complications, highlighting the importance of tailored perioperative management to balance thromboembolic risks and procedural safety. In contrast, corticosteroid use was less common in the oldest elderly group, possibly due to concerns about adverse effects such as immunosuppression and metabolic disturbances. Given the potential role of steroids in managing airway inflammation, future research should explore optimal strategies for balancing their benefits and risks in elderly patients undergoing bronchoscopy.\u003c/p\u003e \u003cp\u003eIn addition, our study analyzed anesthesia methods in the oldest elderly group, revealing that while most patients underwent local anesthesia, a subset (18 patients) received painless bronchoscopy. Perioperative risk was assessed using the ASA (American Society of Anesthesiologists) classification system, with 14 patients classified as ASA grade 2 and four as grade 3 (including one as grade 3E). This assessment enabled targeted intraoperative monitoring and postoperative care. Among those who received sedation, the mean intraoperative oxygen saturation was 99.4%, although 38.89% required non-invasive ventilation for transient hypoxia, which was effectively managed. Six patients experienced transient hypotension requiring vasopressor support, but all recovered with stable vital signs. Notably, despite previous reports of increased postoperative fever, CRP elevation, and nausea following painless bronchoscopy[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], no such complications occurred in our cohort. These findings suggest that, with individualized monitoring and perioperative care, sedation can be used safely in selected elderly patients. When analyzing the entire cohort, no significant difference in complication rates was found between patients who underwent local versus painless bronchoscopy.\u003c/p\u003e \u003cp\u003eThe observed decline in the use of painless bronchoscopy with increasing age likely reflects concerns regarding sedation-related risks in older adults with comorbidities. Although sedation improves procedural tolerance and patient comfort, it may pose higher risks of respiratory depression, hypotension, or delayed recovery. However, our findings demonstrated that, when appropriately managed, sedation did not result in serious adverse events even in patients aged\u0026thinsp;\u0026ge;\u0026thinsp;80 years. This highlights the importance of careful patient selection and tailored anesthesia planning in geriatric populations.\u003c/p\u003e \u003cp\u003eIn addition to anesthesia considerations, the type of bronchoscopic techniques used may also influence procedural safety. Furthermore, many of the bronchoscopic procedures performed in our cohort, such as brushing and bronchoalveolar lavage (BAL), are considered minimally invasive and are generally associated with low complication rates. These techniques are widely used for diagnostic purposes and typically do not result in significant adverse events when performed under standard protocols. Their frequent application in our study population, including among the oldest elderly group, may partially explain the overall low incidence of serious intraoperative and postoperative complications. This reinforces the safety profile of flexible bronchoscopy when using evidence-based, minimally invasive techniques, even in high-risk age groups.\u003c/p\u003e \u003cp\u003eAge-related pulmonary function decline has been well documented in the literature[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Our study confirms this trend, with the oldest elderly group exhibiting significantly lower FVC and FEV1 values, as well as higher rates of emphysema (27.52%) and interstitial lung disease (19.27%). This is consistent with reports indicating that lung function deterioration accelerates with age, increasing the risk of respiratory complications during bronchoscopy[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Furthermore, reduced diffusing capacity for carbon monoxide (DLCO) was more prevalent in the oldest elderly group, indicating impaired gas exchange efficiency. The high prevalence of chronic respiratory conditions such as COPD and respiratory failure in this group underscores the need for cautious procedural planning and appropriate respiratory support.\u003c/p\u003e \u003cp\u003eInterestingly, while some studies suggest that reduced pulmonary reserve increases the likelihood of hypoxemia during bronchoscopy[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], our data showed no significant difference in oxygen desaturation events across age groups, except for a slightly higher rate of transient hypoxia (6.42%) in the oldest elderly group. This suggests that with adequate oxygen supplementation and procedural modifications, bronchoscopy remains a viable option even in patients with compromised respiratory function.\u003c/p\u003e \u003cp\u003eThe use of bronchoscopy for diagnosing malignancy, infection, and interstitial lung disease is well-established[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e][\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In our study, the oldest elderly group had a significantly lower rate of transbronchial biopsy and endobronchial ultrasound (EBUS) use compared to younger patients, likely due to concerns regarding procedural tolerance. Instead, a greater proportion of the oldest elderly patients underwent electronic bronchoscopy (78.90%), reflecting a preference for less invasive techniques. This trend is in line with recent recommendations advocating for the selective use of biopsy-based procedures in frail elderly patients to minimize procedural risk, as age has been identified as a risk factor in the occurrence of complications during or after bronchoscopic lung biopsy.[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e][\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].Moreover, procedure duration was slightly longer in the oldest elderly group, suggesting that greater caution was exercised during the examination. This could reflect more careful maneuvering of the bronchoscope, additional time for oxygenation, or the need for a slower approach due to patient frailty. However, postoperative recovery times remained comparable across groups, suggesting that procedural tolerance in elderly patients can be maintained with appropriate perioperative management. Given the variability in frailty levels, further studies should explore whether individual frailty indices predict recovery outcomes more accurately.\u003c/p\u003e \u003cp\u003eOur study also found that tuberculosis was significantly more prevalent in the oldest elderly group (26.61%), a finding consistent with epidemiological data showing increased TB susceptibility in aging populations due to immune senescence[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Given that TB symptoms in older adults may be less pronounced or atypical, the role of bronchoscopy in providing a definitive diagnosis is particularly important in this population. This underscores the importance of bronchoscopy in diagnosing pulmonary infections in older adults, particularly in endemic regions.\u003c/p\u003e \u003cp\u003eThis study has several limitations. First, as a retrospective analysis, it is subject to selection bias, and certain variables, such as operator experience and procedural modifications, were not standardized. Second, pulmonary function tests, including DLCO, were not available for all patients, limiting our ability to fully assess baseline respiratory function. Additionally, while we stratified patients by age, intra-group variability in frailty and functional status was not accounted for, which may influence procedural tolerance and recovery. Future studies should investigate the impact of frailty indices on procedural outcomes. Such research will be essential to refining procedural guidelines for bronchoscopy in the growing population of the oldest old.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eOur study demonstrates that despite the high prevalence of cardiovascular and pulmonary comorbidities in patients aged 80 years and older, bronchoscopy remains a safe and feasible diagnostic tool when proper preoperative assessment and perioperative management are implemented. The incidence of hypoxia and bleeding was low, and post-procedural recovery was favorable. Future research should focus on refining risk assessment models for elderly patients and exploring AI-assisted bronchoscopy and non-invasive diagnostic techniques to enhance diagnostic efficiency while reducing unnecessary invasive procedures. Future research should focus on refining risk assessment models for elderly patients and evaluating the role of non-invasive diagnostic techniques to improve procedural safety while minimizing unnecessary interventions.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eFB: Flexible Bronchofiberscope\u003c/p\u003e\n\u003cp\u003eCT: Computed Tomography Scan\u003c/p\u003e\n\u003cp\u003eCOPD: Chronic Obstructive Pulmonary Disease\u003c/p\u003e\n\u003cp\u003eFVC: Forced Vital Capacity\u003c/p\u003e\n\u003cp\u003eFEV1: Forced Expiratory Volume in One Second\u003c/p\u003e\n\u003cp\u003eDLCO: Diffusing Capacity of the Lungs for Carbon Monoxide\u003c/p\u003e\n\u003cp\u003eBAL: Bronchoalveolar Lavage\u003c/p\u003e\n\u003cp\u003eEBUS: Endobronchial Ultrasound\u003c/p\u003e\n\u003cp\u003eTBNA: Transbronchial Needle Aspiration\u003c/p\u003e\n\u003cp\u003eASA: American Society of Anesthesiologists\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eK. H.: Data curation, Formal analysis, Writing - Original draft.\u003cbr\u003e\u0026nbsp;L. Z.: Writing - Reviewing and Editing.\u003cbr\u003e\u0026nbsp;J. Z.: Writing - Validation, Reviewing and Editing, Supervision.\u003c/p\u003e\n\u003cp\u003eAll authors reviewed the manuscript and approved the final version for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Guizhou Maotai Hospital Research and Talent Development Fund for the year 2024 (No. MTyk2024-19).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from the corresponding author, Zhang Jianyong, upon reasonable request. Due to privacy considerations, detailed data are not publicly accessible.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the institutional review board of the Affiliated Hospital of Zunyi Medical University and conducted in accordance with the Declaration of Helsinki. Informed consent was waived due to the retrospective nature of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Respiratory Medicine, Affiliated Hospital of Zunyi Medical University, Guizhou, China.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePharmD JAM, MD FS, Bronchoscopy. A Medication Guide to Internal Medicine Tests and Procedures2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFu Y, Ding W. 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Pediatr Pulmonol. 2022;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCongcong L, Yanyan L, Faguang J, Liyan B. The bleeding risk and safety of multiple treatments by bronchoscopy in patients with central airway stenosis. Expert Rev Respir Med. 2023;17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCl\u0026eacute;rigo JC V, Monteiro P, Gon\u0026ccedil;alves JR. C. B\u0026aacute;rbara Interventional Pulmonology Unit, Centro Hospitalar Lisboa Norte, Lisbon, Portugal. Indications and complications of flexible bronchoscopy in very elderly patients. Chest. 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaito Z, Oi I, Ito T, Imakita T, Kanai O, Fujita K, et al. Safety of flexible bronchoscopy and clinical course for elderly patients with suspected primary lung cancer. Thorac Cancer. 2024;15(8):614\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTesauro M, Mauriello A, Rovella V, Annicchiarico-Petruzzelli M, Cardillo C, Melino G, et al. Arterial ageing: from endothelial dysfunction to vascular calcification. J Intern Med. 2017;281(5):471\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThiboutot J, Brown RH. Breathing Life into Pulmonary Physiology: How Age and Body Weight Impair Oxygenation. Anesthesiology. 2019;131(1):7\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumagai K, Tsuruoka H, Morikawa K, Handa H, Mineshita M. Pre-treatment bronchoscopic evaluation in a case of relapsing polychondrits. BMC Pulm Med. 2023;23(1):108.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChotisukarat H, Akavipat P, Suchartwatnachai P, Sookplung P, Eiamcharoenwit J. Incidence and Risk Factors for Perioperative Cardiovascular Complications in Spine Surgery. F1000Res. 2022;11:15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eScandrett KG, Zuckerbraun BS, Peitzman AB. Operative risk stratification in the older adult. Surg Clin North Am. 2015;95(1):149\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLv ZH, Yuan N. Construction of a Risk Prediction Model for Fever After Painless Bronchoscopy. Med Sci Monit. 2020;26:e924911.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang G, Qu Y, Wu Z, Liu W, Luo H, Chen R, et al. Association between low lung function and the increased risk of age-related macular degeneration: A population-based prospective cohort study. J Glob Health. 2024;14:04102.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTran D, Rajwani K, Berlin DA. Pulmonary effects of aging. Curr Opin Anaesthesiol. 2018;31(1):19\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRumbak M, Clum SR. Anticipating, Preventing, and Treating Complications in Patients With Limited Pulmonary Reserve. J Bronchol Interv Pulmonol. 2017;24(2):96\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePark D. Advanced Bronchoscopic Diagnostic Techniques in Lung Cancer. Tuberc Respir Dis (Seoul). 2024;87(3):282\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eR\u0026ouml;der M, Ng A, Conway Morris A. Bronchoscopic Diagnosis of Severe Respiratory Infections. J Clin Med. 2024;13:19.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMondoni M, Rinaldo RF, Carlucci P, Terraneo S, Saderi L, Centanni S, et al. Bronchoscopic sampling techniques in the era of technological bronchoscopy. Pulmonology. 2022;28(6):461\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePocienė I, Gauronskaitė R, Galkauskas D, Mainelis A, Gruslys V, Danila E. Age as a Risk Factor in the Occurrence of Complications during or after Bronchoscopic Lung Biopsy. Geriatr (Basel). 2022;7(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJiang H, Chen X, Lv J, Dai B, Liu Q, Ding X, et al. Prospective cohort study on tuberculosis incidence and risk factors in the elderly population of eastern China. Heliyon. 2024;10(3):e24507.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Bronchoscopy, oldest-old patients, safety","lastPublishedDoi":"10.21203/rs.3.rs-5766113/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5766113/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe safety of bronchoscopy in elderly patients, particularly those aged 80 years and older, remains a concern due to age-related comorbidities. This study evaluates clinical characteristics, preoperative cardiovascular and pulmonary indicators, and bronchoscopy-related complications across different age groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA retrospective study of 349 patients undergoing bronchoscopy was conducted. Patients were categorized into three groups: Young (\u0026lt; 65 years, n = 120), Elderly (65–79 years, n = 120), and Oldest Elderly (≥ 80 years, n = 109). Demographics, cardiovascular and pulmonary indicators, and procedural complications were analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe oldest elderly group exhibited significantly higher rates of preoperative cardiovascular conditions, including arrhythmia (76.15%), hypertension (36.70%), and elevated D-dimer levels (54.13%) (all p \u0026lt; 0.01). Pulmonary function was more impaired, with increased rates of emphysema (27.52%) and respiratory failure (25.69%) (all p \u0026lt; 0.01). However, intraoperative complications such as mild bleeding (93.58%) and hypoxia (6.42%) were not significantly different across groups. Post-procedural recovery was favorable in 96.33% of patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBronchoscopy is generally safe in patients aged ≥ 80 years when appropriate precautions are taken. Careful preoperative assessment is critical in minimizing procedural risks.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration Clinical trial number\u003c/strong\u003e not applicable.\u003c/p\u003e","manuscriptTitle":"Analysis of the Safety of Bronchoscopy in Patients Aged 80 Years and Older: A Retrospective Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-03 07:47:50","doi":"10.21203/rs.3.rs-5766113/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c7e76374-f93a-475d-af2a-b2b4eb5b88a7","owner":[],"postedDate":"April 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-04-14T08:28:25+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-03 07:47:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5766113","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5766113","identity":"rs-5766113","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}