Does "patient-reported discomfort" from bronchoscopy differ over time?

The optimal time to assess patient satisfaction with bronchoscopy has not been established. This study aimed to compare patient comfort scores recorded immediately after bronchoscopy with those obtained at follow-up, 7 to 14 days later.

A total of 240 patients undergoing bronchoscopy were recruited. Immediately after the procedure, patients scored the discomfort they had experienced from 0 (no discomfort) to 4 (severe discomfort). In addition, nursing staff recorded measures of comfort and sedation. At follow-up, patients again scored the discomfort they had experienced during the bronchoscopy.

Complete data were analyzed on 180 patients (75%). The majority of patients tolerated the procedure well, although a significant minority experienced at least moderate discomfort (28.9%). No significant difference was found between the immediate and the follow-up comfort scores (Wilcoxon P=0.79). The comfort score recorded by the nurses was related to both immediate (Spearman 0.22, P<0.01) and follow-up scores (Spearman 0.28, P<0.01) of the patients. A number of variables that may influence patient comfort during bronchoscopy were assessed; only age was found to influence the comfort score. A large number of younger patients (age less than 60) reported a higher immediate discomfort score (χ2=7.69, P<0.05) despite the fact that older patients received lower doses of midazolam (P<0.05). However, the type of samples taken or patient position during the procedure did not influence the comfort score.

The comfort score assessed immediately after the procedure is similar to that recorded at a later date, and it relates to the score assessed by the nursing staff. Younger patients reported higher immediate discomfort.