Characteristics and financial costs of patients with respiratory failure at bronchoscopy.

BACKGROUND

A case-control study was conducted to identify the possible risk factors for acute respiratory failure in patients undergoing bronchoscopy. We also aimed to estimate the financial costs incurred in the care of high-risk patients.

METHODS

All hypoxic respiratory complications that occurred during bronchoscopy between January 2005 and March 2009 were reviewed. Mild hypoxia was defined as the need for up to 6 L of nasal cannula, moderate hypoxia as requiring up to 100% nonrebreather face mask, and severe hypoxia requiring intubation and mechanical ventilation to maintain pulse oximetry above 90%. The Wilcoxon 2-sample test was used to compare continuous groups. Categorical variables were assessed using χ(2), Fischer exact, and Kruskal-Wallis tests. We calculated the cost of medical care for patients admitted to the intensive care unit after bronchoscopy.

RESULTS

During our study period, 26 patients were reported to have hypoxia with bronchoscopy. The mean age for our study group was 66.1 years, and body mass index 26.1 kg/m(2) (SD, 7.6). The study group's mean albumin was 2.9 g/dL (SD, 0.6) compared with 3.3 g/dL (SD, 0.7, P=0.0019), the study group's hematocrit was 32.4% (SD, 5.7) compared with 37.9% (SD, 5.5, P=0.0241), the study group's forced expiratory volume to forced vital capacity ratio ratio was 65.0 (SD, 15.8) compared with 78.0 (SD, 18.8, P=0.0133), and the study group's forced expiratory volume was 59.5% compared with 71.2% (P=0.0606). The study group's mean pCO(2) was 53.7 mm Hg (SD, 18.6). Six patients required intensive care unit admission after bronchoscopy and the total cost of care for this group was $80,353.

CONCLUSIONS

Prescreening of selected patients may reduce respiratory failure and possibly the total cost of medical care.