Flexible bronchoscopy-induced massive bleeding: A 12-year multicentre retrospective cohort study

Area of Science:

• Pulmonology
• Gastroenterology
• Critical Care Medicine

Background:

• Massive bleeding is a critical complication of flexible bronchoscopy.
• Data on its clinical characteristics and prognostic factors are limited.

Purpose of the Study:

• To investigate the clinical characteristics and prognostic factors of massive bleeding following flexible bronchoscopy.

Main Methods:

• A multicenter retrospective cohort study involving 520,343 patients undergoing flexible bronchoscopy.
• Analysis of clinical characteristics and outcomes of 194 patients with massive bleeding.

Main Results:

• The incidence of massive bleeding was 0.037% with a 10.8% fatality rate.
• Therapeutic bronchoscopies posed a higher risk than diagnostic ones (0.059% vs 0.031%).
• Independent poor outcome predictors included age ≥65, tracheal bleeding, blood loss ≥500 mL, and shock; emergency surgery was protective.

Conclusions:

• Flexible bronchoscopy-induced massive bleeding is rare yet life-threatening.
• Key prognostic factors include age, bleeding location, volume, circulatory status, and emergency surgery.